For a situation to constitute patient abandonment, two things must have happened:
The nurse must have accepted the assignment, which establishes a nurse-patient relationship.
The nurse left their assignment without notice to an appropriate person (supervisor, manager, etc.) so that another nurse could provide care to the patient(s).
The following behaviors are NOT patient abandonment but they are employment issues that can lead to facility or organization action:
Failing to call in, not showing up, or arriving late for a shift
Refusing an assignment for religious, cultural, legal, or ethical reasons
Refusing to work in an unsafe situation
Refusing to give care that may harm the patient
Refusing to delegate patient care to an unsafe caregiver
Refusing to work mandatory overtime
Not returning from a leave of absence
Ending employment without sufficient notice for the employer to find a replacement
Refusing to work all remaining scheduled shifts after resigning
Refusing to work in an unfamiliar, specialized, or other type of area when you have had no orientation, education, or experience in the area – such as refusing to float to an unfamiliar unit
Refusing to come in and cover a shift
Giving notice and working only part of the remaining time
Behaviors that are examples of abandonment:
Accepting the assignment and then leaving the unit without notifying a qualified person
Leaving without reporting to the on-coming shift
Leaving patients without any licensed supervision (especially at a long-term care facility with no licensed person coming on duty)
Sleeping on duty
Going off the unit without notifying a qualified person and arranging coverage of your patients
Leaving in an emergency situation
Overlooking or failing to report abuse or neglect
Giving care while impaired
Giving incompetent care
Delegating care to an unqualified caregiver
Failure to perform assigned responsibilities
It's important to know the difference between patient abandonment and an employment issue.
Nurses, you should not accept an assignment that you are unqualified to handle, whether it is because you are exhausted or haven’t been oriented or educated in the area. Once you accept an assignment, you have a duty to provide safe, competent care until you properly hand off care to another licensed provider.
Remember:
Ask for help.
Document carefully.
Be objective and professional when you decline an assignment. You do not have to give detailed reasons for refusing but you should understand what you can and cannot do.