My question is about patient abandonment in a long-term care facility. If I am scheduled for an eight-hour shift and management cannot staff the next shift (because nobody wants to work it), am I required to stay and work the next four hours? Shouldnt covering those hours be the responsibility of my director of nursing? Someone told me that if I provide ample notice that I cannot stay for the next half shift, then the facility DON is responsible for covering those hours. I dont want to jeopardize my license. Could I still be charged with patient abandonment? We do not receive overtime pay after eight hours.
Nancy Brent replies:
The legal concept of patient abandonment has been used in employment situations. It initially was applicable to healthcare practitioner/patient relationships involving physicians in which the healthcare provider unilaterally withdrew from the provision of care to the patient without reasonable notice and without an opportunity for the patient to obtain a new healthcare practitioner. It recently has been applied to employment situations such as the one you described.
The inclusion of abandonment is most probably detailed in the employee handbook under the employee code of conduct or similar provision. In its purest form, patient abandonment would occur when, as an example, the nurse leaves his or her workplace during a scheduled shift and, again most often, does not notify the supervisor of the leaving. However, even when the nurse does notify the supervisor, the employee may also be seen as violating the policy and is disciplined for abandonment.
This charge also can arise when there is no staff member on the next shift to relieve a staff nurse whose shift is ending. Although notice may be given that one cannot stay for more than the assigned shift, this allegation still may be brought forth by the employer.
These provisions are not helpful in creating a good working relationship with nurse employees, and many nurses try to change these types of provisions when they exist in their respective workplaces through membership and active participation on employee policy committees.
Many state boards of nursing have tried to avoid such results by including in nurse practice acts or their rules that these kinds of situations, where the nurse must leave her assigned shift and properly notifies those in charge, or communicates the inability to stay beyond the assigned shift pursuant to the employers policy, are not examples of abandonment for the purposes of imposing discipline on the nurse licensee.
You may want to seek information about what your state nurse practice act states, if anything, about this issue. Reviewing your employee handbook also would be helpful. A nurse attorney or attorney in your state also can provide you with more information in this situation, including whether your state has a statute that prohibits mandatory overtime except in emergency or certain other situations.
Although you stated you do not get paid for overtime for working more than eight hours a day, under the Fair Labor Standards Act, your employer must pay overtime pay under two options: if the employee works more than 40 hours in a seven-day week, or, with the prior agreement with employees, it calculates overtime pay beginning after more than eights hours in a day and more than 80 hours in a 14-day period (the 8/80 rule). The attorney can discuss this issue with you, as well.