When do you actually become resposible for the pt?

[THAT Nurse., MSN, RN, APRN]

I have seen some people talk about seeing the patient board, and the rooms assigned, and simply walking out, or refusing to clock in until the staffing issues were fixed.

From a legal perspective, when do you actually assume liability for a patient? At my hospital, other RNs have said that once you clock in, you have accepted your patients, and leaving is abandonment. I am of the understanding that until you receive report, you have not accepted the patients. (This is why I understand you can refuse report, and not take a patient.)

Does anyone know exactly for sure where the line is, and what our rights are? (Oh who am I kidding, I ought to say responsibilities since we don't have rights...)

If it matters, I am in Tennessee.

[morte, LPN, LVN]

check with your BON, generally speaking you need to "form a professional relationship" ie get report.....

[meandragonbrett]

In TN, a nurse patient relationship must be established. You must physically accept the verbal report from the off going nurse to establish this relationship. You are not responsible until you take report.

[bill4745, RN]

I've always beeen told that your responsibility starts at the end of report.

[diane227, LPN, RN]

It is my understanding that when you clock in and accept the report from the offgoing nurse, you are responsible for the patient. But this is a sticky issue. It is better to refer to the board rules for your state to determine what their definition of patient abandonment is. Because if you refuse an assignment it can be viewed as patient abandonment under certain rules. It is always better for your license to accept the assignment rather than refuse. In that situation it would be important for you to notify the supervisor on duty that you are accepting the assignment but that you feel the assignment is unsafe and why. You then follow this up with a formal letter to your manager, keeping a copy for yourself, of why you felt the assignment was unsafe. If this issue continues over and over or your job is threatened as a result of your bringing your concerns to management, you should then make a formal report to the board of nursing and /or the state department of health. But you better have copies of your census on the floor for that shift and the assignment sheets and you better be ready for a fight. You should do everything you can to resolve this issue with your manager and with hospital management before you go to the reporting stage.