Sunday, April 30, 2006

Refusing to Stay - Patient Abandonment?

Last time I posted I talked about nurses who refuse to perform treatments or give care that they feel is immoral or violates their personal values. This time I want to talk about another controversial practice.

I have talked to nurses from all over the U.S. who have very strong beliefs about patient abandonment. Many facilities use this to coerce nurses into staying past the end of the shift. Calling it patient abandonment they imply or state outright that they will report nurse’s who refuse to stay after their scheduled shift ends to the state nursing board. The implication is that not only are you abandoning patients but now you will be subject to disciplinary action against your nursing license if you leave.

The guilt of leaving patients in the lurch is bad enough but they also throw in the fear of losing your ability to practice nursing.

Well, guess what? Leaving when your shift is over is NOT patient abandonment! Read almost every single nursing practice act or the accompanying policy statement that virtually every nursing board has published on this topic and what you will discover is that this is NOT considered patient abandonment.

In fact, many states consider this practice to be nothing more than forced or mandatory overtime. The use of coercion and blackmail that goes with this practice is so prevalent that many states have passed legislation forbidding the use of forced or mandatory overtime as a routine way to cover shortages in nursing personnel. Maine, Pennsylvania and Washington states are just three of many states passing laws to prevent this shameless harassment and extortion.

What I find most astonishing is that there had to be a law passed. All it would have taken is enough nurses voting with their feet for employers to get the message. Sure it’s scary to tell the boss no. But, how hard is it to give two weeks notice and find another job?

Of course, the type of boss who feels they have the right to demand you leave your own family in the lurch or be terminated for refusing is just downright amazing. You expect that kind of hard-nosed callousness toward people from the military or other professions but not in healthcare.

In places where you don’t have a strong union contract or state law to protect you there are still employers who can and will terminate nurses who refuse to stay on after the shift ends. The real jerks will even threaten to “report you to the board of nursing”. I am not sure I would want to work for them anyway.

That’s where being a travel nurse can be very advantageous. You sign up for 13 weeks. Sure some employers may ask you to be willing to work at least 48 hours per week when you sign up but if you find that mandatory overtime is excessive and the attitude is draconian then when the contract ends it’s on to the next contract thank you very much.

Well, that’s my opinion for this time. I hope that all of the nurses reading this understand that I am not against staying past the end of my shift. I am against being forced to stay past the end of my shift.

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