When the nurse has to leave because of an emergency

[LPNtoBSNstudent]

This is a topic that some of my coworkers have discussed in the past and I am curious to know about others experiences as well.

I was taught and still believe that no matter what, you have to give report and chart before you leave. Here are some of my experiences in the past...

In 1990, when I was in clinicals for LPN school, my clinical instructor pulled me aside and told me that she had recieved a phone call from my mother and she had bad news for me...my grandmother passed away that morning. Ok, so I needed to leave clinicals and at the time, being a 19 year old student, I was surprised that I was required to chart before leaving. However, I did it, no problems.

In 1998, I received a phone call at work that my father was dead at age 51. It was a huge shock. After falling to the floor in shock and a bit of crying I got myself together and finished charting and gave report so I could leave. My coworkers were surprised that I didn't just walk out the door.

My friend was working and found out her 3 year old child had broken her leg and was at the hospital (with my friend's husband-the dad). My friend really wanted to leave to go and be with her child and was LIVID that management would not let her leave because they did not feel it was an emergency. I felt bad for my friend. My friend says that there should be more compassion for nurses who experience crisis.

Another nurse I know got a phone call that (I later found out from her) her daughter was raped. She was able to leave work, but didn't tell anyone why (at the time), except for quite possibly, the nurse manager. She did not report off to anyone but did her charting.

Ok, those are a few of my (and other's) stories. I am curious about your stories and what happens when the nurse has an emergency. What constitutes an emergency (for the employee)? What happens where you work? What if someone has an emergency that they are not prepared to tell someone about yet needs to leave?

[RN4NICU, LPN, LVN]

Haven't encountered this situation myself, so I'm not inclined to judge, but it seems worth noting that when a nurse says, "to hell with this job," it shouldn't mean, "to hell with these patients."

What if a surgeon has a family emergency?

As long as there are other nurses around, it shouldnt mean "to hell with these patients" - everyone could pick up one extra patient for the remainder of the shift for heaven's sake.

If a surgeon has a family emergency, you'd better believe that the rest of his/her scheduled cases for that day are cancelled or postponed, unless the patient consents to a surgeon's partner performing the surgery. I've seen that happen a few times. Would you want YOUR surgeon cutting on you when s/he is worried about a family member?? For that matter, would you want your nurse to be preoccupied with worry for his/her family or would you rather be added to someone else's assignment?

[nurseygrrl, LPN]

If I had an emergency, I would expect my coworkers to pick up my assignment for me for the remainder of my shift. I would do the same for them in a heartbeat.

[jemb]

I think a lot depends on how different people define 'emergency'.

A family member in an accident that resulted in injuries is an emergency.

A family member with a driver's license in a fender bender or with a car broken down is not an emergency in my book.(Well, it may be the driver's emergency, but not yours.) A child who was a passenger in a fender bender and the other parent is not there either -- well, depends on the individual cirumstances.

An ill close family member who has taken the proverbial turn for the worse and is not expected to survive more than a few hours is an emergency if you have a chance of making it to see them, or if you are so distressed by the call that you are unable to continue working safely. When I got that call at work about my mother some 20 years ago, I finished out my shift, and started calling about cross country flights as soon as I got home. The extra three hours I spent finishing my shift wouldn't make a commercial flight leave any sooner or get there any sooner, and since I didn't have the option of a charter flight waiting for me at the airport, I finished the shift.

Had my mother been only an hour away from me, I probably would have told my nurse manager that I had to leave because I had a chance of seeing my mother before she passed, endorsed my patients to other nurses, made sure I had charted my meds and dressings, and left--- in that order.

My thoughts about the person who is taking off every week unexpectedly in the middle of a shift is that this person needs to be more informed of the options available. One 'false alarm' is understandable since she may have received a panicked phone call and had no reason to doubt what she was told. But beyond that, arrangements need to be made in advance for time off if it appears that death is likely to occur soon. If I were that person's manager, I would suggest that she work a limited schedule (four or six hour shifts, perhaps, if she was unable to take personal leave for a length of time. FMLA might also be an option, but only if she is the primary caregiver for the dying person, and has worked 1250 hours minimum in the prior twelve months.

[nursemike, ASN, RN]

As long as there are other nurses around, it shouldnt mean "to hell with these patients" - everyone could pick up one extra patient for the remainder of the shift for heaven's sake.

If a surgeon has a family emergency, you'd better believe that the rest of his/her scheduled cases for that day are cancelled or postponed, unless the patient consents to a surgeon's partner performing the surgery. I've seen that happen a few times. Would you want YOUR surgeon cutting on you when s/he is worried about a family member?? For that matter, would you want your nurse to be preoccupied with worry for his/her family or would you rather be added to someone else's assignment?

I completely agree. I only meant a surgeon wouldn't leave in the middle of a surgery without a replacement (I would imagine that's in place before the surgery ever starts, since the emergency could be the surgeon himself/herself having a sudden, massive MI, for example). What appears to be the consensus, here--hand off responsibly and go--seems pretty reasonable. But I think you have to recognize going in that it's not like flipping burgers--there's more at stake than a job.

[mattsmom81]

I've never had to leave due to an emergency at home, but I've worked with nurses who have. My feeling is let 'em go...and if they are distraught, we should gently pressure them to go.

I've had distraught nurses try to stay on the job and frantically handle emergencies over the phone with family members, which is not appropriate IMO. Some went on to self destruct on the job...scream at patients, coworkers...too emotional to handle the combined stresses. I see them as impaired if they are too upset to function well..and they need to be with their family in time of crisis.

As a young nurse doing teamleading, one of my co-teamleaders got a call her brother was in the ER, hit by a car. We picked up her workload for her no questions asked; and insisted she leave....she held her brothers hand while he died.

I hope my coworkers would let me go no questions asked in a similar situation, and wouldn't hold it against me if I had to leave.

[P_RN, ADN, RN]

One evening I arrived home and the phone was ringing. It was the evening nursing director letting me know my husband had an anaphylactic reaction and was in the emergency room......hmmmm I had left work 6 floors above the ER and driven 60 minutes home. She didn't want to bother me at work. So back I went to the ER on another 60 minute drive.....

I agree with the ones who have said family over job every time. When my father was comatose and near death my nurse manager at the time let me work as unit clerk so I'd be near the phone and be able to leave a moment's notice....she was a great NM by the way.

[tiroka03, LPN]

My dtr with a seizure disorder, called me screaming. She never reacts like that with a seizure. Her dad had just left to go shopping, and she was home alone for 1/2 hour or so. I could make it home in 8 mins. Things had calmed down at work, and so I immediately called my Supervisor and told him, I needed to leave right away and would be back soon. He said, can't you wait for a while? I said no, the keys are locked in the back room, see ya.

I got home and back in 25 mins. She was ok, but the seizure was a dousy.

The thing I knew was I would be only gone for a limited time, and that this supervisor was free to take over. All my meds were current and charting done. Yes, it was an inconvience. But, My child comes first. Bottom line.

I understand about doing your charting. But, it a pinch, I have written, Nurse Jones reported temp 102 to me at 0200. Then I will continue from there. There are so many types of charting. But, in an emergency we make do.

have you ever took a temp for instance, because it was elevated the shift before. When you go to document the fever is down, you find it was never documented on that it was elevated in the first place. It looks strange to document temp is now 98.8, without first documenting that the previous nurse had told you it was high and she had given medication, documented already in the MAR. Even on a good day we forget to document everything.