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Is it legal for RNs to go home/walk out of the facility after their shift if they have left a written patient report for the nurse coming in for the next shift?

Tuesday October 29, 2013
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Question:

Dear Donna,

Is it legal for RNs to leave a written report before another nurse comes in for their shift? At the facility where I work, a long-term acute care hospital, there are many problems with inadequate staffing, which means administrators often have to call in nurses at the last minute. Sometimes the nurse coming in to cover a shift does not arrive before the nurse on duty is scheduled to leave.

I am restricted by my doctor to working an eight-hour shift to allow my body to heal from an injury and am not supposed to jump back into working overtime too quickly, which could lead to re-injury and losing even more time at work.

I was supposed to leave at 3:30 p.m. one day but was unable to because we couldn't find anyone to cover my patients. I ended up staying late and waiting for someone to take my patients. After I left, I called my manager and asked her what we could do to ensure this doesn't happen again. She said I should have written a report and just left at the time I was scheduled to leave.

Leaving written report happens frequently here. One particular nurse leaves at 5 a.m. every shift, and more often than not her reports consist of the name of the patient and their room number but no history, reason for admission or other information at all.

Isn’t only leaving a written report for the next nurse to come on duty considered
patient abandonment?

Concerned

Dear Donna replies:

Dear Concerned,

Because this is LTACH versus a regular acute care hospital, the regulations are different. Without knowing what your facility policies are, what other type of support staff is present on your unit and in the facility and what your state laws are governing LTACHs, I cannot comment on the legality or appropriateness of this situation. While I am not an attorney, issues of "abandonment" are not the same in this type of setting as in a regular acute care hospital.

You do need to find out what is appropriate and legal for your own practice and also to be sure your medical situation is being properly addressed. If you cannot get a satisfactory answer from your supervisor, human resources or your facility/corporate education staff, then I suggest you consult a nurse attorney in your state for clarification. Nurse attorneys are uniquely qualified to interpret the law and your Nurse Practice Act. Find a nurse attorney by asking around or getting a referral from your state chapter of the American Nurses Association (www.ana.org) even if you are not a member or through The American Association of Nurse Attorneys (www.TAANA.org). You can get all of your questions answered in a one-hour consultation. Your concerns may or may not be founded, but you do have to get some answers.

Additionally you can consult someone at your state chapter of the National Association of Directors of Nursing Administration in Long Term Care (www.nadona.org) for help/information. This association addresses the needs of all nurses who work in any LTC setting. You also can contact the education or practice director at your state hospital association.

You need to determine if this is an issue of legality or if it is about your level of comfort with what may be "legal" practice. There's a difference. A poorly written report from another nurse is an entirely different matter that needs to be addressed internally.

Be proactive in getting the information and answers you need and then decide if this is the right place for you to work, or if you should start looking elsewhere.

Best wishes,

Donna


Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://www. Nurse.com/Events.