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Maryland Board of Nursing 
Patricia A. Noble, MSN, RN, Executive Director
Nancy D. Adams, MBA, RN, President

Abandonment

The Board receives many telephone calls from individual nurses and as well as institutions requesting clarification of the issue, Abandonment. Many times these calls are followed with written complaints against an individual nurse alleging that abandonment of patient(s) has occurred. In an effort to clarify this issue and to address a recommendation from the Sunset Review Examiners, the term Abandonment has been defined. In addition, the essential variables that the Board of Nursing examines during an investigation of a complaint of abandonment has also been included. Because of the uniqueness of each nursing situation, the following is a general framework the Board of Nursing utilizes when investigating the allegation of Abandonment.

Please feel free to contact A'lise Williams, R.N. M.S., Director of Nursing Practice at (410)585-1927 should you require further clarification of this document.

August 1993

ABANDONMENT

Abandonment: Occurs when a licensed nurse terminates the nurse-patient relationship without reasonable notification to the nursing supervisor for the continuation of the patient's care.

The nurse-patient relationship begins when responsibility for nursing care of a patient is accepted by the nurse. Nursing management is accountable for assessing the capabilities of personnel and delegating responsibility or assigning nursing care functions to personnel qualified to assume such responsibility or to perform such functions.

The Term Abandonment - What it is not:

The issue of Abandonment, what exactly the term means, and what represents Abandonment becomes cloudy when issues of staffing and reassignment of staff are involved. The issue is further complicated when the exchange between the supervisor and the licensee include implied or overt threats such as, "We will charge you with abandonment if you don't do this.@ This example illustrates the nursing supervisor's lack of understanding and knowledge of their own accountability as a licensed nurse whose practice is also governed by the Nurse Practice Act and his/her responsibility as a agent of the employing facility.

These separate issues of: (1) short staffing, (2) reassigning of personnel, (3) refusing a patient assignment and (4) refusing an extension of the duty hours assigned, are issues which complicate the defining of the term, Abandonment. These four issues represent the shared responsibility between nursing management and the individual licensee, i.e. each participant having responsibility and accountability to assure the patient receives safe care from qualified competent care providers.

Variables To Be Examined:

The variable which need to be examined in each alleged incident of abandonment include but are not limited to:

1. What were the licensee's assigned responsibilities for what time frame? What was the clinical setting and resources available to the licensee?

2. Was there an exchange of responsibility from one licensee to another? When did the exchange occur i.e. shift report, etc.?

3. What was the time frame of the incident i.e. time licensee arrived; time of exchange of responsibility, etc.

4. What was the Communication Process, i.e. whom did the licensee inform of his/her intent to leave; lateral, upward, downward, etc.

5. What are the facility's policies, terms of employment, and/or job description regarding the licensee and call-in, refusal to accept an assignment, re-assignment to another unit and mandatory over-time, etc.

6. What is the pattern of practice/events for the licensee and the pattern of management for the unit/facility. i.e. is the event of a single isolated occurrence or is this one event in a series of events?

7. What were the issues/reasons for why the licensee could not accept an assignment, continue an assignment or extend an original assignment, etc.?

Resources (Written)

1. "A Case of Patient Abandonment", Court Case Nursing '89, May, p. 119-120.

2. Bellocq, Jeanne "Liability For Short Staffing?" (Legal and Ethical Issues) Journal of Professional Nursing, Vol. 4 No. 2, (March-April), 1988, p. 76 and 141.

3. Cushing, Maureen "Accepting or Rejecting An Assignment Part 1: Are You Abandoning your Patients? American Journal of Nursing (November, 1988), pp 1470 t.

4. Hogue, Elizabeth E. Litigation And The Nurse, Eau Claire: Professional Education Systems Inc., 1987.

5. Northrop, Cynthia "Adequate Staffing .It" Nursing '87 June p. 43 Whose Problem Is

6. Northrop C., and Kelly M. Legal Issues In Nursing: St. Louis: The C.V. Mosby Co,, 1987.

7. Alabama Board of Nursing, Regulation Excerpt, Montgomery, Alabama.

8. Alaska Board of Nursing, Regulation Excerpt, Anchorage, Alaska.

9. Arizona Board of Nursing, Advisory Opinion, Phoenix, Arizona.

10. Arkansas Board of Nursing, Nurse Practice Act, Little Rock, Arkansas.

11. Connecticut Board of Nursing, Nurse Practice Act, Hartford, Connecticut.

12. Georgia Board of Practical Nursing, Regulation Excerpt, Atlanta, Georgia.

13. Idaho Board of Nursing, Position Statement, Boise, Idaho

14. Iowa Board of Nursing, Regulation Excerpt, Des Moines, Iowa.

15. Kentucky Board of Nursing, Advisory Opinion, Louisville, Kentucky.

16. Louisiana Registered Board of Nursing, Regulation Excerpt, New Orleans, Louisiana.

17. Louisiana Board of Practical Nursing, Regulation Excerpt, New Orleans, Louisiana.

18. Montana Board of Nursing, Regulation Excerpt, Helena, Montana.

19. Nebraska Board of Nursing, Regulation Excerpt, Lincoln, Nebraska.

20. Nevada Board of Nursing, Regulation Excerpt, Reno, Nevada.

21. New Mexico Board of Nursing, Regulation Expert, Albuquerque, New Mexico

22. New York Board of Nursing, Regulation Excerpt and Position Statement, Albany, New York.

23. North Carolina Board of Nursing, Regulation Excerpt and Position Statement, Raleigh, North Carolina.

24. Oklahoma Board of Nursing, Regulation Excerpt, Oklahoma City, Oklahoma.

25. Pennsylvania Board of Nursing, Draft Regulation Excerpt, Harrisburg Pennsylvania.

26. Rhode Island Board of Nursing, Regulation Excerpt, Providence, Rhode Island.

27. South Carolina Board of Nursing, Regulation Excerpt, Columbia, South Carolina.

28. South Dakota Board of Nursing, Position Statement, Sioux Falls, South Dakota.

29. Texas Board of Practical Nursing, Position Statement, Austin, Texas.

30. Texas Board of Registered Nursing, Informal Position Statement, Austin, Texas.

31. Vermont Board of Nursing, Regulation Excerpt, Richmond, Virginia.

32. Virginia Board of Nursing, Regulation Excerpt, Richmond, Virginia.

33. Washington Board of Registered Nursing, Regulation Excerpt, Olympia, Washington.

34. West Virginia Board of Practical Nursing, Regulation Excerpt, Charleston, West Virginia.

35. Wisconsin Board of Nursing, Nurse Practice Act, Madison, Wisconsin.

Resources (Personnel)

1. Ann Mech, RN, Esq., Assistant Professor, School of Nursing, University of Maryland, Baltimore, Maryland.

2. Lois A.F. McBride, RN, Esq., Attorney At Law, Wright, Constable and Skeen,

3. Margaret Garrett, RN Hospital, Baltimore, Baltimore, Maryland. Esq., House Counsel - Johns Hopkins Maryland.


Last update: July 01, 2011
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