"Abandonment"

[erkantarik]

I need advice on how to deal with a situation occuring in a hospital setting, with a final semester nursing student in an AD program.

This student nurse was assigned a stable patient. The clinical instructor had found out that the client had a spouse who was also a patient on another unit (ICU). The instructor indicated to the student that "it would be nice" to allow the stable client to visit his spouse. The student nurse, on that statement" accompanied the client, in a wheelchair, to visit with his spouse. Staying there with the patient, the patient said to the student, "We're OK. Would you please leave us alone for a little while?"

Deferring to these two patients' wishes, the student nurse left for about 5 minutes to use the toilet.

Upon returning to the two patients, the student nurse returned the "visiting patient" to his unit.

The student nurse, when getting a final evaluation was told that due to "abandonment" he was to fail the clinical for the semester and of course would not graduate.

Any ideas or suggestions on this matter? Does this actually fit the definition of "abandonment" and if so why was the student nurse not discuplined at the time of the incident.

Can attorneys get involved in matters such as these?

Thanks so much for your help.

[weirdRN, RN]

Talk to you Nursing Director first then go over her head, then over their heads. Then go get a lawyer. along the way, make sure you document everything down to farting while on the toilet.

This sounds really uncalled for. Another personality conflict with a large ego.

[NYCRN16]

This is ridiculous! We did this very same thing when my grandmother was dying of a stroke, my grandfather was also a patient on another floor and we brought him to her room WITHOUT the nurse present (we had permission from the nurse and his doctor to transport him via wheelchair to her unit) and he was in the room alone with her for about 1/2 hour with us sitting outside. The issue of abandonment was never brought up! This patient who went to visit his wife in the ICU is well within his rights to do so as long as he is competent and stable for transport. He has the right to privacy with his wife for a reasonable amount of time. What about when a postpartum patient goes to visit her child in the NICU? If she is post c-section she is also a surgical patient and noone would ever say that she was "abandoned" because she left to go to another unit! What about patients that have the right to go outside and smoke cigarettes? Are they abandoned? I see patients all the time outside smoking in thier gowns and then they go back inside. Its a hospital not a prison, and unless they are being held there for psych issues under lockdown or are confused, they have the right to move around as they please. I hope this student can fight this. Maybe there is a hospital policy that shows this is allowed? What about contacting the omsbudman (I know spelling) and he or she can clarify what the patients rights were. If the patient has a right to do it then the nurse cannot be held accountable.

[WoosahRN, MSN, RN]

Sigh, I can't wait to graduate. My school has so many politics it's ridiculous. They change the rules according to whatever they want. What one class had to do, the next doesn't and vice versa. Expectations are never known. If they like you, you get scholarships. If you don't pass, the only way you can stay in the program is again, if they like you. And they have said this to us. And this has been going on for more than 15 years (I worked with someone that graduated there in the early 90s...with the same teachers, and the stories are the same). I am just trying to play by the rules and stay under the radar for one more year. I just had a friend who was struggling in one of our classes. She studied all the time but wasn't testing well. Instead of helping her, our instructor told her "you are really great in clinicals and a really caring person, but you should just give it up."!!!! This was not the first time the teacher handled things this way. Unfortunatly my friend did not pass by 2% and now has to go back and deal with that same teacher. I don't know the whole story with this student (from the original post) but I am sad about the whole situation.

[LPN1974, LPN]

Nurses don't stay within arms reach of their patients even while the patient is on their own floor and in his/her own bed, during the time the nurse is on duty.

Abandoment for going to the bathroom. That is ridiculous.

[Antikigirl, ASN, RN]

Hey..odd thought here but isn't it mandatory by most state labor laws that if a person must go to the bathroom they must be allowed to do so, even in urgent bathroom situations! They don't have to wait for a break...but that time may be taken off your break time???? Same with hydration and cleanliness...if you have to get a drink of water your facility must provide it, and allow its consumption 24/7...same with cleanliness for safety (especially hospital)...

That can be another twist in support of this instructor having a large case of chronic cranial rectal inversion???

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I guess I too am guilty of pt abandonment. Since I always go to the bathroom w/o getting another nurse to cover my patients. I am gone a total of about 3 minutes or so. (BR is in the hallway right by pt rooms and nurses station) Wouldn't everyone be abandoning their pts if they left the bedside to chart? Don't we have multiple pts? We can't be with them all at the same time! This is crazy. I would fight it tooth and nail.

[LPN1974, LPN]

Hey..odd thought here but isn't it mandatory by most state labor laws that if a person must go to the bathroom they must be allowed to do so, even in urgent bathroom situations! They don't have to wait for a break...but that time may be taken off your break time???? Same with hydration and cleanliness...if you have to get a drink of water your facility must provide it, and allow its consumption 24/7...same with cleanliness for safety (especially hospital)...

That can be another twist in support of this instructor having a large case of chronic cranial rectal inversion???

:roll

[Antikigirl, ASN, RN]

OR a large anthropodic symbiote located rectally with no hope of surgical or medicinal cure???? (large spider up the keester!).....

LOL, I am in a funny mood today! I have a million of these medical translations for human dynamics!

[Jennerizer, ASN, RN]

In no way is that considered abandonment. If I were him, I would appeal most definitely. I don't see how a "student" nurse could truly be charged with abandonment anyways. Just because he/she is assigned to a patient, the ultimate responsibility of that patient falls back on the nurse that works for the hospital. I really don't see anything that was done wrong in the first place.

[Tweety, BSN, RN]

Ideally?!

Isn't it a breach of security?

Imagine the surprise of the ICU nurse to discover someone unknown, unexpected and unattended, at the bedside of a critical patient.

I'll bet her/his heart skipped a beat.

And hopefully with 10 seconds returned to normal when said nurse found out it was her husband upon appraoch and asking. No need for said nurse to be so dramatic. But I know what you're saying where I work it's the primary nurse who has to approve all visitors for their critical patient. People just don't go walking in.

[Tweety, BSN, RN]

This is ridiculous! We did this very same thing when my grandmother was dying of a stroke, my grandfather was also a patient on another floor and we brought him to her room WITHOUT the nurse present (we had permission from the nurse and his doctor to transport him via wheelchair to her unit) and he was in the room alone with her for about 1/2 hour with us sitting outside. The issue of abandonment was never brought up!

This is a common practice with stable patients. Often on my units spouses are in another unit from a car crash, or their infants or children are in the hospital next door (they have to sign a waver and have a doctor's order to leave the hospital and go visit their children next door.)

Even on the unit, the nurses leave their patients to go to the bathroom.

It definately sounds like as the op says, this is just an excuse to get rid of a student they wanted to get rid of for a while.

[NrsJena]

Tweety- I agree with you, now I've heard everything....