Did you ever "neglect" a patient??? - page 3

While we were in nursing school, our instructor informed us one day that if you are working at a current job and quit without giving a notice or walk off a shift, it is considered neglect and they... Read More

  1. by   justmanda
    Quote from Stitchie
    In IL we are employed 'at will', which leads to my question:

    If you are employed in an at-will state, and your NM gets a burr up her backside or staff reductions are occurring, if you get the boot does the following apply:

    -- If you have received report, and are terminated on the spot for whatever reason or (sent home) are you theoretically liable? I realize that it is up to the nurse manager to cover your assignments, but what if s/he isn't on the unit at the time?

    -- I was involved in just such an incident. One of my fellow co-workers came on shift and was receiving 4 of my 5 patients.

    I was giving her report when I noticed she was weeping quietly. As it turned out, her husband was hospitalized in severe CHF and was in the ICU. She was unable to begin her shift, but we found coverage. I stayed an extra 4 hours/4 patients, as this was creating a 12-hour day for me, something not 'recommened' where I worked at the time for new grads. Another nurse was willing to come in 4 hours early.

    The charge nurse -- really took the 'leadership initiative' and was amazing. Our unit experienced an all too rare moment of teamwork and cohesiveness.

    When I reported back to work for my next shift, there was a 'request' from the NM to come see her.

    I went to the office at 0900. She said "Close the door" (always a sure sign of a dressing-down). She asked for my version of what happened (!!!??????!!!) and I told her that I offered to stay.

    Apparently I had run into the holy grail of 'unauthorized' OT by about 4 hours.

    I told her that Nurse X was not able to concetrate on report, so she didn't receive report entirely. The charge nurse was cooperative in our shift-covering. "But what about this OT? If you go home now I have no one to cover your patients and you will be in violation of your license and facility policy -- patient abandonment."

    I told her that as far as I knew, if it was OK w/the Charge nurse, it's OK to switch assignments or change staffing. It's the Charge Nurse's unfortuante responsibility to get coverage for sick calls, etc...The Nurse Manager said that I was still in unauthorized OT.

    At that point, as I was getting tired of the circular argument. I said "Mary (not her real name), you can pay the OT, change the schedule or fire me. But we did the right thing at the time, so please explain the problem to me, because I don't see it".

    The other nurse (Nurse X) was fired for patient abandonment the next day.

    The general consensus was that Mary, Nurse Manager, was looking for a reason to fire an experienced, good, and (probably expensive) nurse.

    So much for team work.

    Thanks for reading a long post. Sorry if I rambled.
    That is an incredible story! I can't believe how unreasonable your NM was being about a staffing crisis on your floor. A crisis you helped remedy by WORKING and extra four hours. She acts like you were sleeping on the clock. And no concern about the poor nurse whose husband was in ICU? Unreal. She should be reported to your higher-ups. Sounds like a sweat shop to me. With the nursing shortage the way it is, it amazes me that some of these NMs act like their job is the last good job on earth -- that one would be willing to be treated like crap to keep it. The truth is, a nurse can quit one job and find another one on the way home...and still have time to stop for lunch. I'm sure the CEO of your hospital would be interested in learning about how a dedicated employee, who bailed the floor out when they were in a bind, was treated by his NM for his good deed. And how an experienced RN, who was emotionally distraught over her critically ill husband, was CANNED just because she had the audacity to have personal problem! I am just mortified. Please tell me this NM got some flack for her insensitive and stupid behavior.
  2. by   BabyRN2Be

    I read your post and I agree with the others. What the NM did was wrong, to fire that nurse whose husband was in ICU. Where, exactly, is her heart?? If it was her husband that was seriously or critically ill, wouldn't she want to be with him?

    My mom (a retired RN) has told me about medication aides who have just walked off the unit and not come back. The other staff just assumed she was going on a smoke break, but after 20 minutes, she didn't return and couldn't be found on the hospital grounds. She was very young and probably didn't see the possible ramifications of leaving pts w/o telling anyone.
  3. by   jsteine1
    Outrageous abuse of power of the part of the NM! I hope nurse X gets an attorney because she was really abused under the circumstances.
    All workplaces have a defined disciplinary process, usually a few clear steps before a termination occurs. !. Verbal warning, 2 written warning. 3.If no improvement, then a term is legal. In this situation, when a nurse was under extraordinary strain, you and the charge nurse did the moral, eothical and compassionate thing. You made it possible for Nurse X to spend precious last hours with her husband. Thank God for people like you.

    For an individual who even had the dedication to show up while her husband was critical is amazing. I'm a widow and have been down that road.

    If the charge nurse agreed to your overtime, I dont understand why you were harrassed by who is essentially the charge nurses superior. The chain of command and authorities need to be aligned there.

    Sounds like a labor attorney would have a lot to work with considering the way employees are handled even when there are extenuating circumstances at your facility.
    1. no process was followed
    2. The nurse tried to work, but was unable.
    3. Patient care was covered by you and your additional hours sanctioned by a charge nurse.
    4. This scenario doesnt fit into the job abandonment category. It was an unforseen emergency.
    Last edit by jsteine1 on Jul 27, '05 : Reason: add
  4. by   ICU_floater
    In response to the OP, on a very hairy day, when the next shift is comming into hell, short staffed, we DO warn them "not to clock in" until they have reviewed the assignments. We do use this only for the rare occasion when management HAD access to additional staffing, or had the option to obtain staff at a premium rate of pay... which management refused.

    therefore, we protected our coworkers from walking in to a volitile and unsafe staffing situation where med errors and patient neglect would result due to staffing.... Know what? 5 day shifters, 5 night shifters all standing arround for an hour, while supervision and management are scrambling for staff. This does get resolved if legit. I also work for a "at will" state. they couldn't fire 1/2 the staff.

    Mind you... this is only to be used in the extremes. When someone needs to leave emergently we suck it up, take up the slack and hit the phones.... NEVER would abandonment with out the extreme of up and leaving without report be called. This also covers those who just want to go, as no nurse will accept report until coverage is found... if their claim is BS. (and you know when it is, if unsure you just truck along and wait for them to show their colors later).
  5. by   kthnscr8
    Oh yes, and I have had to be the one to turn in a nurse for JOB ABONDENMENT, which is the term they use. But when your investigated for it they charge you with neglet of a patient, or patients, depending on your setting. Also depending on the state you live in your license may be revoked for that charge. It is a serious issue et the nursing board takes it serious.

    Quote from Debbie_LPN
    While we were in nursing school, our instructor informed us one day that if you are working at a current job and quit without giving a notice or walk off a shift, it is considered neglect and they can report you to the boards.

    Is there any truth to this??