10 Most Common Examples Of Patient Abandonment In Nursing
Written By:
Darby Faubion
Darby Faubion RN, BSN, MBA
Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Darby lives in Louisiana and loves exploring the state’s rich culture and history. Darby has a passion for caring for veterans and a special interest in those affected by post-traumatic stress disorder. In her quest to make a difference for veterans, she founded a non-profit called “Operation Battle Buddy.” Read Full Bio »» RN, BSN, MBA
If you are a nurse, you know there are many responsibilities that come with your job. It is crucial for nurses to understand the ethical principles and legal ramifications of their roles and what constitutes appropriate and inappropriate behaviors. One thing I have found that many nurses lack a clear understanding about is patient abandonment. You may be wondering, “What are common examples of patient abandonment in nursing that I need to know and avoid?”
Having been a nurse for more than 20 years, I have witnessed situations where nurses committed patient abandonment and the impact it had. In this article, I will share the 10 most common examples of patient abandonment in nursing and give you some tips on how to avoid them.
What are the Common Examples of Patient Abandonment in Nursing?
(The following are the 10 most common examples of patient abandonment in nursing.)
EXAMPLE #1: Failure to Perform Assigned Nursing Duties
Every nursing job has specific duties that must be performed. Simply being present at work does not mean you cannot get into trouble for abandonment. On the contrary, if you go to work and do not complete your assigned duties, this is considered an act of patient abandonment.
For example, a wound care nurse who worked at a facility where I did prn work came to work one day and left without completing wound care for four patients on our hall. Each of those patients was supposed to have a daily dressing change because of various wounds. There was no emergency or clear reason why the care was not provided. She simply stated that she "got behind" and did not have time to catch up. Instead of reporting to the charge nurse and asking for help, she left the wounds unattended. A nurse on the following shift realized the dressings had not been changed because of the date on the dressings. This is a clear example of patient abandonment, one that cost a nurse her job.
EXAMPLE #2: Leaving Your Unit Without Having Someone to Cover Your Patients
When you get to work and begin your shift, you become accountable for the care of patients assigned to you in your unit. If you leave your unit without ensuring someone is there to cover patient care, this is an example of patient abandonment in nursing. All patients have the right to expect availability of staff and continuity of care. Leaving patients unattended increases the risks of falls and injuries and could result in disciplinary action, including termination from your job.
EXAMPLE #3: Sleeping on the Job
Having to explain sleeping on the job as an example of patient abandonment in nursing makes about as much sense to me as needing to tell someone they should not eat laundry pods. Nevertheless, most detergent labels have a “Do Not Eat” label on them. I honestly cannot tell you how many times I have found nurses asleep on the job! It does not matter if you are just down the hall from a patient’s room. If you are asleep, you have abandoned your post and responsibilities.
Trust me; I know what it is like to work long hours and feel completely exhausted on the job. When I worked the graveyard shift, there were nights I wondered if I should have just called and had someone work in my place because I was so tired. Nevertheless, once I showed up for a shift, I became legally responsible for providing care to the patients on my ward. Had I fallen asleep on the job, I would not have had to worry about getting someone to cover my shift because I would have been fired.
EXAMPLE #4: Delegating Care to Unqualified Staff
As a registered nurse, there are times when it is appropriate for you to assign patient care to other members of your team. While delegating care is common, it is crucial that you know to whom an assignment can be delegated. If you
delegate care to a staff or team member who is unqualified or lacks a license or necessary certification, this becomes a situation where patient abandonment occurs.
I have worked with nurses in the past who have tried to argue in their defense that staff should not accept assignment of tasks for which they are not qualified. While that is true and each staff member is accountable for their own actions, your job as a registered nurse is to promote patient safety and quality of care, which means ensuring assignments are appropriately delegated to qualified team members.
EXAMPLE #5: Failure to Report Neglect or Abuse
If there is one thing I have zero tolerance for, it is patient neglect and abuse. Right there at the top of my zero-tolerance list is when nurses are aware of neglect or abuse and turn a blind eye instead of reporting it.
Having knowledge of patient neglect or abuse and not reporting it is a serious example of patient abandonment in nursing. It is crucial that you understand that as a nurse, you are a
mandated reporter, which means if you suspect abuse or neglect, you are required by law to report it. Therefore, if you suspect that another nurse is neglecting or abusing a patient, you should follow ethical and legal imperatives and report the situation to the appropriate people and through the appropriate channels. I recommend familiarizing yourself with your facility's protocol for reporting incidents of abuse or neglect.
EXAMPLE #6: Providing Patient Care While Impaired
Perhaps one of the most frightening things I can imagine a patient experiencing must be knowing that the nurse who is supposed to be caring for them is impaired in any way. Several years ago, a nurse on my team came to me to report that she thought another nurse was under the influence of some type of drug or alcohol. I remember going down the hall where the nurse was assigned, and at first, I could not find her. When I did locate her, she was in an unoccupied room, asleep in the bed. Thankfully, that situation ended in a much better way than it could have.
Suppose, though, that I had not been alerted or that the nurse had not found somewhere to fall asleep. She may have attempted patient care that could have ended up in a patient injury or worse. Although I much prefer that the nurse passed out and did no harm to anyone, it did not change the fact that by being drunk at work and incapable of providing care, she abandoned her patients.
EXAMPLE #7: Accepting an Assignment, Then Leaving Your Unit Without Notifying a Qualified Person
For patient abandonment to occur, a nurse must first accept an assignment, which initiates the start of the nurse-patient relationship. Once you accept an assignment, if you leave your unit or the facility without notifying a supervisor or other qualified person, you will be considered as having abandoned your patient. Keep in mind that accepting an assignment does not have to be a long, drawn-out process. Accepting an assignment can be as simple as showing up for your shift, clocking in, and finding out what floor or hall you are assigned to work that day. Once you are in the facility and on company time, leaving can constitute abandonment.
EXAMPLE #8: Home Health or Hospice Nurse Fails to Provide Scheduled Home Visit
Home health and hospice patients are entitled to the same rights as patients in other healthcare facilities, including the expectation of competent, timely care. Upon admission to these types of care settings, a care plan, including a schedule of the frequency of visits is established. Once a plan of care is established and a nurse is assigned to a patient, failure to follow through with that plan, including making scheduled visits, is considered abandonment. It is one of the main examples of patient abandonment in nursing that occurs outside of hospitals and other inpatient healthcare facilities.
EXAMPLE #9: Not Making Reasonable Arrangements for Continuation of Care
If you work in a facility that has 24-hour nursing services, such as a hospital, nursing home, or other inpatient facility, part of providing appropriate patient care is ensuring the continuation of care after your shift by participating in
care coordination. Most healthcare facilities have end-of-shift reports, which allows nurses leaving the shift to discuss patient progress and any issues with oncoming nurses. Leaving your facility without first ensuring that another nurse is available and ready to assume care of your patients is another example of patient abandonment in nursing.
EXAMPLE #10: Getting Angry at a Patient and Refusing to Continue Providing Their Care
As nurses, we are not allowed to pick and choose the patients we deem worthy of providing care to. There are times when patients may be rude, act inappropriately, and may make you angry. Even if you feel justified in being angry, you do not have the right to simply walk away and discontinue your obligation to care for the patient. Once a nurse-patient relationship is established by accepting an assignment, you must continue care until such time as care is not needed or you hand care off to someone else. In cases where the situation is uncomfortable, or you feel it could become unsafe, talk to your supervisor as soon as possible and ask for help or reassignment, but do not abandon your patient.
My Final Thoughts
It is crucial for all nurses to understand their professional and legal responsibilities regarding patient care. An important question to ask and understand is, “What are common examples of patient abandonment in nursing?”
In this article, you learned about the 10 most common examples of patient abandonment in nursing. As a nurse and healthcare educator, I believe it is important for all nurses to be mindful of their duties and obligations and to strive to provide high-quality patient care by acting professionally and avoiding any behaviors that could lead to poor patient, nurse, or organizational outcomes, such as patient abandonment.
List Of Sources Used For This Article
1.
“7 Main Ethical Principles in Nursing + Why They’re Important” (
nursingprocess.org)
2.
“What Is the Importance of Delegation in Nursing?” (
indeed.com)
3.
“What Are Nurses Responsible for Reporting?” (
Mandated Reporter Training)
4.
“Care Coordination and the Essential Role of Nurses” (
American Nurses Association)
Darby Faubion, RN, BSN, MBA
Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Her work history includes clinical experience in pediatrics, mental health, addiction and behavioral disorders, geriatrics, wound management, and communicable disease. Darby has worked in hospitals, long-term care facilities, and home health and hospice agencies. Darby also has experience as a nursing and allied health educator at both community college and university levels. Her love for nursing and nursing education led to her becoming a test-taking strategist and NCLEX prep coach.