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. 

[PMFB-RN, RN]

1 hour ago, Jedrnurse said:

Thanks for the clarification. How's it going with the recruiting for the newly open position?

No idea. I'm not involved 

[PMFB-RN, RN]

22 minutes ago, 2BS Nurse said:

I have been hearing of situations where supervisors are sending Ubers to nurses homes to bring them to work earlier than scheduled (if a car isn't available to them at that time). I would think this is a liability issue!?!

How might it be a liability issue? For who?

[Jedrnurse, BSN, RN]

3 minutes ago, PMFB-RN said:

How might it be a liability issue? For who?

Good question...

[spotangel, DNP, RN, NP]

PMFB! 
Love the  nickname!

You did come to the rescue!

I know a lot of hard working LPNs but this one sounds like my nursing instructor used to say ,”A Specimen “!!

Ps-You saved that child’s life. Did she get her arm back?

[~Shrek~]

On 11/17/2021 at 10:45 AM, PMFB-RN said:

How might it be a liability issue? For who?

I am not a lawyer, but I believe that a lawyer can straighten this out. What comes to mind is:

1. Is the employee on the clock when the Uber comes to pick them up?

2. If the Uber is late and the employee is late as a result, does the employee have to face consequences for being late? 
 

3. if someone barfs in an Uber, there is a fee. Who is responsible for the fine if the employee vomits in an Uber? 

4. If there is a car accident, and the employee is injured, who pays the medical expenses? Is this a workers comp issue?

However, I do think these are things a good lawyer can sort out without much work. But it is something I would consult a lawyer with just in case (if I was an employer)

 

[SunDazed, BSN, RN]

Totally nuts. 

When I was an LPN I worked swingbed/acute on med-surg at a small, rural hospital. The other LPN who worked opposite me twice handed off comfort care patients as dying in morning report, sadly both had already passed. 

She did not like comfort care patients, so she never went in the rooms. Passing it off once, could happen to anyone. Twice? Not so much. Especially, when the second one had clearly been gone for awhile. 

[PMFB-RN, RN]

6 hours ago, ~Shrek~ said:

I am not a lawyer, but I believe that a lawyer can straighten this out. What comes to mind is:

1. Is the employee on the clock when the Uber comes to pick them up?

2. If the Uber is late and the employee is late as a result, does the employee have to face consequences for being late? 
 

3. if someone barfs in an Uber, there is a fee. Who is responsible for the fine if the employee vomits in an Uber? 

4. If there is a car accident, and the employee is injured, who pays the medical expenses? Is this a workers comp issue?

However, I do think these are things a good lawyer can sort out without much work. But it is something I would consult a lawyer with just in case (if I was an employer)

 

Ya, I hadn't considered any of those things. I've never ridden in a Uber and never lived anywhere where where the service was available. 

   The critical access hospital I mentioned in the OP will send out a 4x4 truck or even a snowmobile to get staff into work.  Usually it's the medical director (MD) because he owns a fleet of snowmobiles, me in my 4x4 or other employees who volunteer. 

[PMFB-RN, RN]

On 11/20/2021 at 8:57 PM, spotangel said:

PMFB! 
Love the  nickname!

You did come to the rescue!

I know a lot of hard working LPNs but this one sounds like my nursing instructor used to say ,”A Specimen “!!

Ps-You saved that child’s life. Did she get her arm back?

   I definitely wasn't disparaging him because he is (or actually was, I've since learned that his license was revoked) an LPN. I just used that as something to call him since I wasn't going to mention names. The vast majority of LPNs I work with are fantastic.

    I heard that she did not get her arm back, but was alive and well.

[PMFB-RN, RN]

On 11/12/2021 at 9:32 AM, Stillcare23 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? 
I

I could go in because it was previously arranged that I make myself available while the DON was on vacation and I was compensated for doing so. 

   This is a REALLY small NH and attached hospital. I've filled every RN roll there at one time or another. Mostly I cover the ER. Now during COVID it occasionally happens that they have intubated ICU patients overnight and I usually will help them with those patients. In the past they would never keep a critical vented patient overnight but area ICUs are overflowing and sometimes there is no place to transfer them to. We only have one part time respiratory therapist on staff. When there is an intubated patient the RT, the CRNA and I take turns managing the vent. The three family physicians who practice there have no idea how to manage a vented patient. The CRNA pinch hits as an intensivist. 

    I have a blast there and get to do things and fill rolls I never would in the big medical center where I work full time. 

[Hannahbanana, BSN, MSN]

On 11/22/2021 at 2:31 PM, ~Shrek~ said:

1. Is the employee on the clock when the Uber comes to pick them up?

It depends on whether they are or not, which sounds silly, but many employers don't pay you for your commute time, so you're probably not on the clock

On 11/22/2021 at 8:44 PM, PMFB-RN said:

2. If the Uber is late and the employee is late as a result, does the employee have to face consequences for being late?

Probably yes. You are responsible for getting to work before your shift starts; if you're not driving yorself, you should allow for this sort of thing.

On 11/22/2021 at 8:44 PM, PMFB-RN said:

3. if someone barfs in an Uber, there is a fee. Who is responsible for the fine if the employee vomits in an Uber?

The person who vomits. Sorry. Don't go to work if you're vomiting or likely to.

On 11/22/2021 at 8:44 PM, PMFB-RN said:

4. If there is a car accident, and the employee is injured, who pays the medical expenses? Is this a workers comp issue?

That depends. Many employment contracts for work comp coverage (work comp is insurance, you know) do cover (some) employees from door to door, I.e., for their commute time to-from work, and certainnly for travel in the course of work, I.e., home visits or meetings c clients. Ask.