My former manager insisted that once I clocked in, I am legally responsible to my patients even though I have not been given report on the assigned patients. Does this make any sense?
Dear Nancy replies:
Although there may be more to the situation than you describe in your question, generally speaking, once an employee, including a nurse, clocks in for his or her shift, the nurse is considered at work and ready for his or her assignments. The issue is not getting report on your assigned patients. Rather, the issue is that you have showed up, signed in for work and are ready for work.
As a result, a nurse cannot simply leave work without reporting off to those who are required to know that you are leaving the workplace. If you do leave without reporting off, or in some instances, do report off but still leave the workplace, an employer often sees this as patient abandonment. Because you are included in the number of staff the employer/nurse manager counts on to provide the needed care to those on the unit on which you work, the nurse-patient ratio is decreased. Boards of nursing may see leaving without reporting off as required as unprofessional conduct or, in some states, as patient abandonment.
If your concern is that you are not comfortable with the patients that have been assigned to you, whether in terms of the number of patients or their conditions or both, discussing this with a current manager would be essential so that you are not undertaking an unsafe patient-nurse ratio or you are not assigned patients for whom you cannot provide competent care to because of a lack of skills, expertise or even orientation to their required needs.
If your patient assignment is not altered by your nurse manager, you can always seek guidance from “higher ups” in nursing administration, such as the nurse director of the unit or service in which you work or the CNO. The employer’s grievance policy is also an option for you if you believe your assignments are too heavy, beyond your skills and capabilities as an RN or you are being singled out unfairly in this process, especially on a regular basis.