Staffing and patient abandonment

[LightMyFire]

Here's the situation: Oncoming shift nurse is no call, no show. No one can come in to pick up the shift. Oncoming shift is already overloaded and refuses to take an extra 3 pts each (don't blame them, they already have 7 each, grid states 5, busy med-surg floor). House supervisor says, "stay put." I have to be back at 7 am. Our NPA states that failure to stay beyond scheduled shift is NOT abandonment; it's a staffing issue for which the facility is responsible. What would be he correct thing to do if staffing is their problem but no one will take report?

[nmercer1]

I think we can all agree that this was a staffing issue. We can all also agree that we would stay because we truly would not abandon our patients. The real issue is safety. Is she safe to continue working? Where does the facilities responsibility to the patient begin when there is a staffing shortage? Are you expected to stay every day after a 12 hour shift? What about other obligations after your shift ends-like getting children to school, family member to dialysis, etc.

I would never just leave but I would have a serious talk with my manager about the implications of the low staffing numbers. What is happening to the no call no show nurse? What happens when I leave and find another job because I do not feel like a valued employee? What happens next time?

I hope they truly appreciated the fact that you and another nurse stayed to help! The nurse manager should have been called in to take those patients!

[moonmaid50, ASN, BSN, MSN]

Check your state as to overtime for nurses. In my state there is a law on the books which reads:

21-5F-3. Hospital nursing overtime limitations and requirements.

(a) Except as provided in subsections (b), ©, (d), (e) and (f) of this section, a hospital is prohibited from mandating a nurse, directly or through coercion, to accept an assignment of overtime and is prohibited from taking action against a nurse solely on the grounds that the nurse refuses to accept an assignment of overtime at the facility if the nurse declines to work additional hours because doing so may, in the nurse's judgment, jeopardize patient or employee safety. (b) Notwithstanding subsections (a) and (g) of this section, a nurse may be scheduled for duty or mandated to continue on duty in overtime status in an unforeseen emergent situation that jeopardizes patient safety.

© Subsections (a) and (g) of this section do not apply when a nurse may be required to fulfill prescheduled on-call time, but nothing in this article shall be construed to permit an employer to use on-call time as a substitute for mandatory overtime.

(d) Notwithstanding subsections (a) and (g) of this section, a nurse may be required to work overtime to complete a single patient care procedure already in progress, but nothing in this article shall be construed to permit an employer to use a staffing pattern as a means to require a nurse to complete a procedure as a substitute for mandatory overtime.

(e) Subsection (a) of this section does not apply when a collective bargaining agreement is in place between nurses and the hospital which is intended to substitute for the provisions of this article by incorporating a procedure for the hospital to require overtime.

(f) Subsection (a) of this section does not apply to voluntary overtime.

(g) In the interest of patient safety, any nurse who works twelve or more consecutive hours, as permitted by this section, shall be allowed at least eight consecutive hours of off-duty time immediately following the completion of the shift. Except as provided in subsections (b), © and (d) of this section, no nurse shall work more than sixteen hours in a twenty-four hour period. The nurse is responsible for informing the employer hospital of other employment experience during the twenty-four hour period in question if this provision is to be invoked. To the extent that an on-call nurse has actually worked sixteen hours in a hospital, efforts shall be made by the hospital to find a replacement nurse to work.

Each hospital shall designate an anonymous process for patients and nurses to make staffing complaints related to patient safety.

(h) Each hospital shall post, in one or more conspicuous place or places where notices to employee nurses are customarily posted, a notice in a form approved by the commissioner setting forth a nurse's rights under this article.

Check your state laws & keep in touch with your state nurses association as they can be your advocate in these matters.

Good luck

[GinginRN]

The unit/facility sounds like a recipe for disaster. Darned if you do, darned if you don't. Bet your bottom dollar, when something happens, the mistake will end up being directed to the nurse/staff, resulting in termination and possibly a complaint to the BON. I have witnessed this first hand. Does not matter if unit is short staffed, potentially putting patients and staff in danger. My advice is, run while you can.

[SENSUALBLISSINFL, BSN, RN]

@ weslieluvYes, I am one of them...hoping since graduating last year for the chance to work.

To the OP, Interesting post. What did you do for your next shift? Did you work?