There is a lot of confusion swirling around the issue of patient abandonment. Not only is patient abandonment defined differently in each state, but each state’s definition leaves a lot of room for interpretation. So what exactly is patient abandonment?
Definition
With regards to patient abandonment, the majority of states follow a definition similar to the American Nursing Association’s (ANA) definition:
“A unilateral severance of the established nurse-patient relationship without giving reasonable notice to the appropriate person so that arrangements can be made for continuation of nursing care by others.”
A key word in this definition is “established.” This means that the nurse already accepted the assigned patients, and then left without proper notification and/or continuation of care.
Examples
- The most common understanding of patient abandonment is when a nurse just walks off the job and leaves his/her patients without another nurse. We should all understand the consequences of this decision and its dangerous impact on patient care.
- Another interpretation of patient abandonment can include leaving without reporting to the oncoming nurse. What if it’s the end of your shift and the oncoming nurse is a no-show? If there is no one available to assume responsibility of your patients, boards of nursing do not support a nurse leaving his/her patients without coverage. As for the length of time a nurse is required to stay, (otherwise known as “mandatory overtime”) that is determined by each state’s Department of Labor. Some states have laws prohibiting mandatory overtime.
- Falling asleep while on duty can also be interpreted as patient abandonment. It’s not good enough that the nurse is physically present; patients need constant monitoring and a nurse who can quickly react to situations, so if he/she is catching some zzzz’s at the nurse’s station, that’s a problem.
How do I Protect Myself?
Being found guilty of patient abandonment is a serious matter. Consequences can include termination and disciplinary action on your license. First of all, travelers should always review the individual state laws that apply to where they’re working. It’s a good idea to be aware of what standards you’re being held against. Information can be found on boards of nursing websites and your Account Manager can also provide additional information.
Other tips:
- Never leave without telling anyone, and/or giving report to a competent colleague.
- It’s not ideal to call off work, but if you’re legitimately ill, notify your employer at least 4 hours before the start of your shift. This is a better choice than showing up sick, accepting patients and then being physically unable to finish your shift.
- If you become sick during your shift, immediately inform the charge nurse or supervisor. Allow enough time for them to find an adequate replacement if necessary.
- If an employer asks you to work in an unfamiliar area that does not match your experience, and you feel it’s a risk to patient safety (and your license) immediately call your Aureus Account Manager. (If it’s after 5 pm Central Time, call the main Aureus number and select the prompt for the Emergency Pager Service.) Problems ensue when you accept an assignment and then later determine it’s unsafe.
Key Takeaways
Even though some guidelines are established, there is still enormous room for interpretation. When a board of nursing investigates patient abandonment concerns, they’re reviewed on a case-by-case basis. The board’s main focus is the established relationship and the responsibility of the nurse to the patient. Educate yourself on each state’s definition of patient abandonment and to ensure you’re aware of the facility’s policies, procedures and staffing practices. In addition, consider the situation. Facilities have the responsibility of ensuring shifts are properly staffed, however we all know unavoidable situations arise such as a natural disaster. Keep in mind that patients need your care regardless of the situation. Staying late until a replacement is found is not ideal, but it’s in the best interest of patient safety. If it becomes a pattern, you can discuss this with your Account Manager.