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Practice Guidance
Abandonment

NDAC 54-01-03-01 defines “abandonment” as accepting the client assignment and disengaging the nurse and client relationship without giving notice to a qualified person.  Behavior that demonstrates professional misconduct includes abandoning a client who is in need of or receiving nursing care and may be grounds for disciplinary action (NDAC 54-02-07-01.1 (10).

For client abandonment to occur, the nurse/registrant must:

1. Have first ACCEPTED the client assignment, thus establishing a nurse client relationship; AND then
2. DISENGAGED the nurse client relationship without giving reasonable notice to the qualified person (supervisor, colleague, etc) so that others can make arrangements for continuation of nursing care.

Examples of client abandonment include, but are not limited to:

• Leaving the client without adequately providing arrangements for coverage
• Leaving abruptly without giving the supervisor or qualified person adequate notice for replacing the nurse  
• Leaving without reporting to the oncoming shift
• Accepting an assignment of client care and then leaving the nursing unit or client care setting without notifying a qualified person
• Sleeping on the job for a portion of the shift, making them unavailable to assigned clients

Situations NOT considered to be client abandonment, but are examples of employer-employee or contract issues of which the Board has no jurisdiction (salary, work conditions, hiring and termination policies):

• No call/no show for work
• Refusal to work mandatory overtime
• Refusal to accept an assignment or a nurse client relationship
• Refusal to work additional hours or shifts
• Not returning from a scheduled leave of absence
• Ending the employer-employee relationship without providing the employer with a period of time to obtain replacement staff for that specific position
• Refusal to work in an unfamiliar, specialized, or “high tech” area when there has been no orientation, educational preparation or employment experience
• Resigning from a position and not fulfilling the remaining posted work schedule
• Refusal to float to an unfamiliar unit to accept a patient assignment (Both AZ & SC have this specification added).

Facilities/Organizations are strongly encouraged to have written policies that establish circumstances/criteria for mandatory overtime as a condition of employment, as well as how the mandatory overtime is resolved.  Failure of the licensed nurse to comply with such policies is an employer-employee issue of which the Board has no jurisdiction.

References:
American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements
Brent, N. (2013). Are You at Risk for an Allegation of Patient Abandonment? Retrieved from CPH Avoiding Liability Blog: https://www.cphins.com/are-you-at-risk-for-an-allegation-of-patient-abandonment/

Other States with Advisory Opinions/Position Statements that support this Opinion:
Arizona Board of Nursing, Advisory Opinion 1/16
Minnesota Board of Nursing, FAQ 2001
New York Board of Nursing, Practice Information 8/15
South Carolina Board of Nursing, Position Statement 3/18
South Dakota Board of Nursing, Statement 12/18
Texas Board of Nursing, Practice Statement 1/18
Washington Board of Nursing, Interpretive Statement 11/12

Adopted: 7/00
Reviewed/Revised: 01/19