Patient Abandonment

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Specializes in acute rehab.

I just wanted to ask this question for some clarification. From my understanding, patient abandonment is when you actually accepted patient care and leaving without giving a report to another nurse coming in to take care of that patient. I went from full time to prn at this place. I love my coworkers there, but I don't really trust the managers or administrators. I was a charge nurse there when the supervisors were away and a full-time floor nurse. I dreaded being a charge nurse there as there was only myself putting ordres in, calling the doctor, scanning paper, and checking all the other stuff such as correct temp on refrigerators and making sure everything is on the crash cart as well as looking over the other nurses and all of the patients. It gave me really bad anxiety and is the main reason I went prn. I have tried to tell them in the past that I no longer want to do charge nurse as that is not what I sign up for, but yet they still put me there sometimes. I have work at this facility for a few years and get along with a lot of my co-workers hence I still want to stay here as prn. I already told the manager that I'm not interested in a charge nurse position and is there prn as a floor nurse. Would it be patient abandonment if I come in to see my name on the board as a charge nurse and just walk out? I'm not taking any reports yet.

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As long as you hadn't clocked in or received report, I don't see where it would be, but I also don't see them keeping you around-even as PRN-if you did that (unless they were truly desperate for help which is a warning sign of a bad facility inofitself).

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Specializes in Psych (25 years), Medical (15 years).
1 hour ago, redsnapper19 said:

I already told the manager that I'm not interested in a charge nurse position and is there prn as a floor nurse. Would it be patient abandonment if I come in to see my name on the board as a charge nurse and just walk out? I'm not taking any reports yet.

The very few times that I've come in extra in my 17 years at Wrongway, I said at the time of acceptance, "Unless I'm on the unit that I want, and with the staff you have told me I will be working with, I will not accept the assignment. I will not clock in".

It seems you have made yourself clear about not accepting the charge nurse assignment, redsnapper. Sometimes, we just have to force their hands if they do the bait and switch routine.

I concur with StillSearchingRN on the abandonment thing.

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It wouldn't be patient abandonment, but it would be a very childish and unprofessional thing to do.

A better thing to do is notify your manager the next time you find yourself in charge (especially if you were not hired as charge) and say, "I think there has been a mistake because my name is listed as charge. Who would you like to assign that role to for this shift?" Stay silent and wait for a response.

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It is not abandonment. A response above says "as long as you hadn't clocked in," but just as an fyi, clocking isn't a factor in accepting an assignment/establishing a nurse-patient duty.

If you didn't have an assigned patient load and were in a strictly administrative role that day, you could probably even walk out mid-shift without it being abandonment since all patients would have nursing coverage. (That'd be a terribly crappy thing to do to your co-workers and should never happen. I'm just making the point that abandonment is very specific to patients being left without a nurse who has accepted their care.)

Instead, this is an employment issue, so you're more likely to face repercussions from your employer - suspension, termination in a non-rehireable status, etc.

When you spoke with your manager about the anxiety being charge gives you and why you were switching to PRN, did she agree not to make you charge anymore?

If so, I think it'd be fine at the beginning of a shift to call her and make other arrangements.

If not, out of consideration to your team, I think you should stick it out for the day, even if it means calling to say "This will be my last shift." There's plenty that I'm competent to do that I don't *like* to do. As long as I would be safe doing it, I'd prefer to help my team instead of making a point to management at the team's expense. Make your stand after you get them through the day.

If you and your manager have clearly established and agreed upon this boundary, yet you're still having anxiety and mistrust, it may be a good idea to just drop this PRN gig and keep up with your work friends in your personal life.

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Agree with the above. If you have an understanding with them that you will not be placed in the CN position and then you come in to find yourself assigned as such, call and find out who is going to be doing the role that day as you had already settled the matter previously.

If they don't come up with an alternative then give your 2 weeks' notice or make that your last day if you absolutely must.

As another alternative, if this is a place that you generally enjoy, it is safe, they try to provide high quality nursing care and you get along well with your coworkers, you could consider revisiting anxiety management with a professional in attempt to have it so that anxiety is not limiting you from something that is otherwise good in your life.

[Sorry one more comment about that last part: Try to increase objectivity as far as what causes you to feel anxious. For example: Do you get in trouble/get written up if you de-prioritize the recording of refrigerator temps while trying to satisfy your other more important duties? If so...yes, that is a problem. But if not, then refrigerator temps are not worth that much anxiety.]

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Specializes in ED, ICU, Prehospital.
Quote

Monday by FacultyRN

It is not abandonment. A response above says "as long as you hadn't clocked in," but just as an fyi, clocking isn't a factor in accepting an assignment/establishing a nurse-patient duty.

As far as I know---in my 20 odd some years---unless and until you receive report on someone---you are not responsible.

Would you characterize your fear as "if someone sees me" (whether or not you're clocked in)---and then I decide I don't want the assignment and then I protest by going home---as some type of legal violation of your nurse practice act?

Because it's not. Until you are willingly accepting the patient as your responsibility--you aren't responsible. If this were the case---every nurse in the hospital is now responsible for every patient in the hospital. Just because your body is in the department---doesn't mean you are there to take care of anybody.

Will it be bad for you administratively and with your co-workers? Probably. Just as the orifice sucking nurse who gets all of the plum assignments because they're pals with the CN is resented and eventually causes a lot of strife in the unit---you would be seen as the diva (wrongfully, but have you not learned that people don't really care whether something is true--it only matters if this person wants to believe it's true?) that gets her way by throwing a tantrum and walking out (thereby screwing over her teammates)---you do understand that admin will throw you under the bus when it comes to blaming you for the chaos that ensues when you refuse your assigned duties?

I've had NMs do the assignment 5 minutes before walking out the door (with their coat on)---and running for the exit---so that things like this don't touch them. Resentment? Yeah. And most NMs' thought process is----so what you gonna do about it? Quit? I'll badmouth you. Transfer? I'll prevent that. Refuse? I'll make sure everyone knows you are Diva Nurse Who Believes She's Special.

It's a no win situation. NMs usually choose to force the person to do a distasteful job that has no choice but to accept it. Can't quit. Can't transfer. Can't speak up.

It's not abandonment. And if someone accuses you of this? I would start rethinking where I'm working.

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