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Who is responsible for my patient left in the unit when I'm away for a lengthy test with another patient?

Wednesday May 15, 2013
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Question:

Dear Nancy,

I work in a critical care unit. The other day I had to travel with one of my patients for a 2 1/2 hour MRI scan. I worried about my other patient who was left behind in the unit, as the other nurses I was working with were very busy with their own patients. Who is responsible for my patient in the unit when I'm away for a lengthy test? We do give a report to the other nurses before we leave the unit.

Carl



Nancy Brent replies:

Dear Carl,

The main legal concern you have under the circumstances you described is making sure your handoff to the other nurses on the unit who will be caring for your other patient is accurate and complete. Although your nurse colleagues are busy with their patients, you cannot be in two places at the same time. Therefore, the information you give them about your patient still on the unit is helpful to them in caring for that patient.

If the handoff information is not complete and accurate, you may be found liable for not meeting the standard of care and the standard of practice for information that is to be given when giving report to your nurse colleagues.

There are many resources about handoffs available to you. One is "Handoffs: Implications For Nurses" by Mary Ann Friesen, Susan White, and Jacqueline Byers, 2008 in Patient Safety And Quality: An Evidence-Based Handbook For Nurses; Rockville, MD; Agency for Healthcare Research and Quality (Chapter 34). It is available at www.ncbi.nlm.nih.gov/books/NBK2649.

It also might be a good idea to raise this issue with your ICU nurse manager and the CNO. Adequate staffing on any unit is essential, and the ICU is no exception. One or two additional staff members who stay on the unit when a nurse colleague must accompany a patient for tests or other reasons is a good risk management approach. For this issue, you might want to check the American Association of Critical-Care Nurses webpage (www.aacn.org). Click on the Clinical Practice tab, and when the drop-down menu appears, click on Staffing.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.