I'm an agency nurse, showed up for my shift read my assignments on their sheet, and quickly ran through the H&P's... assignment was DANGEROUS and I wasn't about to lose my license for some extra money (felt unsafe practicing). I tried to find the charge... she didn't show up in 10 min... start time was approaching... nurse was pressuring me to start report... so I left. Called my agency, they couldn't get a hold of the charge either. They asked if I would take a reduced load. I said did the charge say I could? She said no, she wants you to come talk to her. I said no, they are going to try to force me to take report I want her to confirm via telephone first that they will reduce my load. She said they wouldn't do that. So I said I was leaving. I let my agency know I didn't feel safe working there and that I hadn't accepted report.
So what constitutes "establishing the nurse/pt relationship" is it accepting my shift... taking report....or what?
I hate the word "reasonable" .... did I give "reasonable notice" given the situation?
The Board's Statement is wishy washy. It does not address your question, as it never states when a nurse is considered to have accepted the responsibility of giving care. Read the first sentence. They mention nothing about nurse safety, only patient safety. How can a patient be safe if her nurse is not safe, though? Still, they refuse to take a stand, certainly not one tipped in favor of the nurse.
I think you should probably have spoken with the current Charge Nurse if the one from your shift wasn't there yet. And/or you should have spoken to the DON or Shift House Supervisor. Or immediately called your agency before leaving the unit.
I can't give you a definitive answer, as the MO BON doesn't give you one. Hopefully, case law is in your favor if this ever does become an issue.
I applaud you for standing up for yourself, for going in early (and presumably for free) to check histories and workload. I'm jealous that you can afford to say no. Of course, you know you won't be re-hired by that facility, right? Still, you did the right thing for your license. As long as nothing comes of it. I think. What a bunch of liars those people at the hospital are, too! Refusing to state that your workload would be only so many patients!
Why not speak with some attorneys in your state and see what they say? Or call the BON anonymously and run this scenario by them, without using your home or other "identifiable as you" phone. See if you can get persons who decide these matters to set your mind at ease. I tried it once and the woman in charge of the department got real mad, wouldn't commit to anything.
First, check with your BON to see if they have the same criteria. Your BON may further define sleeping on the job. Secondly, just off hand, I would say 'closing your eyes' for a short period of time is going to be considered sleeping on the job if you are supervising patients at the time. You and only you are responsible for being alert and able to do the job you've accepted with the patient load you took report for . If your facility will allow you to take a break, go into a break room and power nap for 15-30 minutes, then great but I would definitely check the policy on that and never, but never, count on that getting to happen. In other words, don't go to work expecting to get to sleep. Our main concern is patient care and safety. If you are not safe to work, then don't go to work. Trust me, I'm not going to have any sympathy for your sleep deprivation if my loved one dies because you were 'closing your eyes for a short period of time'.
True, true, but what about the nurse who is threatened and bullied by bosses to work when she knows she is not safe? What then?
To the PP who asked if it's abandonment if you have to leave work suddently due to a serious medical or family/personal crisis while on duty and become unfit to continue to be on duty to give that required proper patient care - no reasonable person would think it's abandonment.
I read all of the previous posts - wow, my hat is off to all of you. You are one strong bunch of assertive nurses!
The Board's Statement is wishy washy. It does not address your question, as it never states when a nurse is considered to have accepted the responsibility of giving care. Read the first sentence. They mention nothing about nurse safety, only patient safety. How can a patient be safe if her nurse is not safe, though? Still, they refuse to take a stand, certainly not one tipped in favor of the nurse.
I think you should probably have spoken with the current Charge Nurse if the one from your shift wasn't there yet. And/or you should have spoken to the DON or Shift House Supervisor. Or immediately called your agency before leaving the unit.
I can't give you a definitive answer, as the MO BON doesn't give you one. Hopefully, case law is in your favor if this ever does become an issue.
I applaud you for standing up for yourself, for going in early (and presumably for free) to check histories and workload. I'm jealous that you can afford to say no. Of course, you know you won't be re-hired by that facility, right? Still, you did the right thing for your license. As long as nothing comes of it. I think. What a bunch of liars those people at the hospital are, too! Refusing to state that your workload would be only so many patients!
Why not speak with some attorneys in your state and see what they say? Or call the BON anonymously and run this scenario by them, without using your home or other "identifiable as you" phone. See if you can get persons who decide these matters to set your mind at ease. I tried it once and the woman in charge of the department got real mad, wouldn't commit to anything.
Kooky,
You are correct, the board response was lacking in that particular area. However, that was a position statement. Basically a guideline but not pertinent in all cases. In the boards wisdom, they follow a case by case basis. Which is good for us. For instance, the, " reasonable prudent nurse doctrine", which is a friend to the nurse. "Mitigating circumstance" is often used as well, whereby, the board may not exonerate, but will reduce at their discretion, the penalty. In some slam dunk cases, the board may totally exonerate. This is when you find folks in an up roar, they will start finger pointing and blaming, feeling a person got away with murder. This too, is to our benefit. Say, your employer or opposing attorney, used illegal practice to prove said case, or you were on a floor as the only nurse with 60 patients, the board may at it's discretion, throw all of it out. Very rarely is the letter of the law used, because very few things, if anything, is black and white. Besides, the BON is subject to law. For that, we all should be grateful!
The board is not out to take our hard earned license. You hear folks, employers and mostly young nurses threatening, " you will lose your license". Or you will see on threads, people trying to prove their point, you can't do this, article, section states...and they print "out of context" a portion of what they are trying to prove or even the actual rule, but never taking into account, the case by case decision process. This is when I get snippy, but am learning to just go on to another thread and say nothing.
Nurses know so much more than they think and even less of what they do not know. We need to go with our gut in certain situations, our subconscious mind is constantly at work giving us the heads up or yelling Stop. We need to Know our Nurse practice act in our state. We need to keep learning, updating and relearning tort and civil law. But also be assured that when we take responsible action, we have nothing to fear. Thanks for letting me piggy back on your excellent post! Peace!
You are correct, the board response was lacking in that particular area. However, that was a position statement. Basically a guideline but not pertinent in all cases. In the boards wisdom, they follow a case by case basis. Which is good for us. For instance, the, " reasonable prudent nurse doctrine", which is a friend to the nurse. "Mitigating circumstance" is often used as well, whereby, the board may not exonerate, but will reduce at their discretion, the penalty. In some slam dunk cases, the board may totally exonerate. This is when you find folks in an up roar, they will start finger pointing and blaming, feeling a person got away with murder. This too, is to our benefit. Say, your employer or opposing attorney, used illegal practice to prove said case, or you were on a floor as the only nurse with 60 patients, the board may at it's discretion, throw all of it out. Very rarely is the letter of the law used, because very few things, if anything, is black and white. Besides, the BON is subject to law. For that, we all should be grateful!
The board is not out to take our hard earned license. You hear folks, employers and mostly young nurses threatening, " you will lose your license". Or you will see on threads, people trying to prove their point, you can't do this, article, section states...and they print "out of context" a portion of what they are trying to prove or even the actual rule, but never taking into account, the case by case decision process. This is when I get snippy, but am learning to just go on to another thread and say nothing.
Nurses know so much more than they think and even less of what they do not know. We need to go with our gut in certain situations, our subconscious mind is constantly at work giving us the heads up or yelling Stop. We need to Know our Nurse practice act in our state. We need to keep learning, updating and relearning tort and civil law. But also be assured that when we take responsible action, we have nothing to fear. Thanks for letting me piggy back on your excellent post! Peace!
Kooky Korky, BSN, RN
5,216 Posts
The Board's Statement is wishy washy. It does not address your question, as it never states when a nurse is considered to have accepted the responsibility of giving care. Read the first sentence. They mention nothing about nurse safety, only patient safety. How can a patient be safe if her nurse is not safe, though? Still, they refuse to take a stand, certainly not one tipped in favor of the nurse.
I think you should probably have spoken with the current Charge Nurse if the one from your shift wasn't there yet. And/or you should have spoken to the DON or Shift House Supervisor. Or immediately called your agency before leaving the unit.
I can't give you a definitive answer, as the MO BON doesn't give you one. Hopefully, case law is in your favor if this ever does become an issue.
I applaud you for standing up for yourself, for going in early (and presumably for free) to check histories and workload. I'm jealous that you can afford to say no. Of course, you know you won't be re-hired by that facility, right? Still, you did the right thing for your license. As long as nothing comes of it. I think. What a bunch of liars those people at the hospital are, too! Refusing to state that your workload would be only so many patients!
Why not speak with some attorneys in your state and see what they say? Or call the BON anonymously and run this scenario by them, without using your home or other "identifiable as you" phone. See if you can get persons who decide these matters to set your mind at ease. I tried it once and the woman in charge of the department got real mad, wouldn't commit to anything.