Nurses who are forced to work overtime

[Asystole RN]

i have heard from several employers, colleagues and friends that refusing to work overtime or doubles was considered patient abandonment.

employers like to use this threat to coerce nurses to stay to meet their staffing needs to avoid using registry or properly filling pool/prn positions. this is the azbn's position on the subject.

http://www.azbn.gov/documents/advisory_opinion/ao%20abandonment%20of%20patients.pdf

janice k. brewer governor

joey ridenourexecutive director

arizona state board of nursing

4747 north 7th street, suite 200 phoenix, az 85014-3655

phone [phone] fax - [phone]

e-mail: [email protected] home page: http://www.azbn.gov

n:\advisory opinions\approved advisory opin\ao abandonment of patients.doc

opinion: abandonment of patients

approved: x not approved:

date: 11/02

revised date: 3/06, 11/09

originating committee:

within the scope of practice of x rn x lpn

scope of practice committee

advisory opinion

abandonment of patients

statement of scope

registered nurses (rn) and licensed practical nurses (lpn) are required to provide reasonable notice to the supervisor for the continuity of patients care, rather than terminate the relationship without notification, which is defined as abandonment. the following requirements constitute patient abandonment:

i. general requirements

a. the nurse must have first accepted the patient assignment, thus establishing a nurse-patient relationship. accepting a patient assignment varies from setting to setting and requires a clear understanding of workload and agreement to provide care, and then

b. disengaged the nurse-patient relationship without giving reasonable notice and report to the qualified person (supervisor, nurse, etc.) so that others can make arrangements for continuation of nursing care.

c. examples of patient abandonment include, but are not limited to:

i. leaving without giving the supervisor or qualified person adequate notice

ii. leaving without giving report to a qualified person

iii. accepting an assignment of patient care and then leaving the nursing unit or patient care setting without notifying the qualified person

d. situations not considered to be patient abandonment, but are examples of employer- employee or contract issues of which the board has no jurisdiction (salary, work conditions, hiring and termination policies):

1. no call/no show for work

2. refusal to accept an assignment or a nurse-patient relationship

3. refusal to work mandatory overtime

4. refusal to work additional hours or shifts

5. ending the employer-employee relationship without providing the employer with a period of time to obtain replacement staff for that specific position

6. refusal to work in an unfamiliar, specialized, or "high tech" area when there has been no orientation, no educational preparation or employment experience

7. resigning from a position and not fulfilling the remaining posted work schedule

8. refusal to "float" to an unfamiliar unit to accept a full patient assignment

an advisory opinion adopted by azbn is an interpretation of what the law requires. while an advisory opinion is not law, it is more than a recommendation. in other words, an advisory opinion is an official opinion of azbn regarding the practice of nursing as it relates to the functions of nursing. facility policies may restrict practice further in their setting and/or require additional expectations related to competency, validation, training, and supervision to assure the safety of their patient population and or decrease risk.

ii. rationale

to provide the nursing community with guidelines to clarify those circumstances which may be characterized as patient-abandonment.

iii. references

california board of nursing, (2009). scope of practice. retrieved from www.rn.ca.gov/practice/rns/htm

kentucky board of nursing. (2009). scope of practice. retrieved from www.kbn.ky.gov/practice/aos.htm

maryland board of nursing. (2009). scope of practice. retrieved from www.mbon.org/main.php?v=norm&p=0&c=practice/decregs.htl

texas board of nursing. (2009). scope of practice. retrieved from www.bne.state.tx.us/practice/gen_practice.html#scope_of_practice