Patient Abandonment

[PMFB-RN]

For the last 20+ years I've been casual at a tiny (12 bed) rural critical access hospital. I mainly work there because its a lot of fun and I'm often the only RN on duty.

The hospital has an attached small nursing home. It's usually staffed with one nurse, usually an RN but sometimes an LPN at night and 2 or 3 CNAs.

Last week my phone rang in the middle of the night and it was the DON of the hospital/nursing home calling me from out of state where she was on vacation. She asked my to come in and cover the nursing home for a few hours as the LPN on duty couldn't be found.

One of the CNAs went to talk to the nurse and couldn't find him. After a search of the bathrooms and other usual places failed to turn up the nurse the CNA called the DON, who called me and the police.

I know NOTHING about nursing home nursing. I've spent my whole career  in critical care and ER but I agreed to go in to "just be there". I arrived at about 3AM, the LPN had been missing for about an hour. 

The only deputy sheriff on duty in the (very rural) county showed up and conducted a search of the surrounding area that also failed to find the missing nurse.

About an hour before shift change (so absent about 4 hours) the missing nurse strolls in through the front door and was very surprised to see me there. I called off the cop and also let the DON know her missing LPN had returned. I questioned him and he didn't hesitate to tell me that he had left to spend some time with his girlfriend and, even more shocking, admitted that he often would visit her during his shift and didn't understand what the problem was "everything was quiet".

The DON asked me to inform him he was fired and collect his badge and keys from him. She has since been in contact with the state board of nursing and is fully confident he will lose his license. I sure hope he does. I had to write a report of the discussion I had with him when he arrived back to the NH for the board.

I'm blown away that a licensed nurse would see no issue with leaving his patients for hours when there was no other nurse in the building. 

[Rose_Queen, BSN, MSN, RN]

23 minutes ago, londonflo said:

I thought rural access hospitals had some federal funding to help staff the hospitals with RNs so that they can do the follow through with assessment, intervention and most importantly (this applies to the RN role only) evaluation. Staffing with an LPN only does not show the hospital really understands the different roles of each licensure. 

This situation does not affect the actual hospital but a nursing home.

On 11/8/2021 at 9:52 PM, PMFB-RN said:

She asked my to come in and cover the nursing home for a few hours as the LPN on duty couldn't be found.

[PMFB-RN, RN]

35 minutes ago, KKstillcares said:

You did your job. Wouldn’t want anything to do with that place good relationship or not. Not protected ever. Bottom line what happend if you couldn’t go in? Do they use you for DON coverage? 
if you couldn’t get to site…. Then what? You? Liable? Very sneaky, twisted sick systems. 
What is the policy for that? They call you? Do they have others too they can call if no DON? Weird and I would cut ties, period. People will find a way to drag, twist snd turn. You did right, pt saftey first then reported that. Howver turns into a massive hunt to blame. Can’t they call the police insight if missing “persons”. Leaving the bulging not permitted usually at night. Least around here it is. Either way Pt saftey snd care was compromised and awful to hear. Awful. I

It was prearranged that I would be available to cover in an emergency while she (DON) was on vacation. 

    This is the closest and only hospital within and hour plus drive to my house. Both my kids where born there.

    I commute 3 hours to my regular job.

    There is no reason to cut ties. This was a fluke and an emergency.  I had agreed and made myself available to cover emergencies. 

[Stillcare23]

It is a hospital.   

[PMFB-RN, RN]

30 minutes ago, londonflo said:

I thought rural access hospitals had some federal funding to help staff the hospitals with RNs so that they can do the follow through with assessment, intervention and most importantly (this applies to the RN role only) evaluation. Staffing with an LPN only does not show the hospital really understands the different roles of each licensure. 

This was in the nursing home, not the hospital.  They are attached through a long covered hallway.  In this state it's common for nursing homes to be staffed with LPNs. When there is no RN on site there needs to be an RN on call for the LPN. I was on call.

    Though I have never worked in the nursing home,  I have responded over there to address emergencies while working in the ED of the hospital. 

    The hospital chief nurse is also the DON of the nursing home. We are talking about a 12 bed hospital and a 24 bed nursing home. They represent the only health care facilities in the county. 3 of the 4 bordering counties don't have hospitals at all.

[Stillcare23]

I am sorry. Awful experience. I can tell you it does happen. DON came in middle of night found staff in patients empty beds fast asleep, staff gone. The stores go on. It is scary. 

[Stillcare23]

Sounds like your stuck. I was in that position. I get it job, great relationships. Commute. Understood. You are now upset, can not even Beleive your eyes and a victim of something that probably is “norm” happens often and should be looked at by the DON. People *** their mouths out of fear. 
You did what was right and what you agreed too. It is a shame that humans vow to take care of other humans and neglect, abandon, the list goes in. The Nurse showed poor moral character, bad judgement, neglect, and abandoned duties and that is sad.  I am positive this isn’t “new” first time and those CNA good job for them. Most people don’t report out of fear. So sad. 

[amoLucia]

PMFB - thank you for clearly explaining what the system is like for LTC/NHs. I was figuring you situation was that. Not IDEAL, but in realty, it is much the norm. The system DID work as it was planned for in case of an emergency, which was not anticipated, but that's what you plan for.

BTDT. Weird things happen in NHs!

[Stillcare23]

You did what you were asked. Then more. I have a question. What happens  things went missing during hat time?  Do you thrn become responsible for those missing thing? Hospital property, meds, anything? 

[Stillcare23]

2 hours ago, KKstillcares said:

 

[PMFB-RN, RN]

16 hours ago, Stillcare23 said:

You did what you were asked. Then more. I have a question. What happens  things went missing during hat time?  Do you thrn become responsible for those missing thing? Hospital property, meds, anything? 

I'm not responsible for anything that happened before I arrived on the scene and only responsible for my practice and the supervision of the CNAs after I've arrived. 

[Stillcare23]

You did your job. Wouldn’t want anything to do with that place good relationship or not. Not protected ever. Bottom line what happend if you couldn’t go in? Do they use you for DON coverage? 
I

[Tj]

That's absolutely crazy. I'm not sure what he was thinking but fortunately none of those patients fell out of bed hit their head and then subsequently passed away or else this will be a totally different discussion. What he did is the epitome of patient abandonment and should definitely lose his nursing license.