Nurse Abandons Patient by Leaving Shift Without Report

It’s 19:35 and I have gotten report on all but one of my patients. Who was the day shift RN for room 225? I ask the Unit Coordinator (UC) if she could check the day shift assignments and let me know. Becky. She’s already gone home for the night. Wow. I head straight down the hall to lay eyes on the patient and complete a brief assessment. The patient was admitted two weeks ago, she has surgical dressings on her abdomen, and she is clearly confused. I spend the next 15 minutes clicking through the chart trying to learn about her complicated course of treatment, active orders, and her baseline assessment.  When Becky came back in the morning, she casually apologized for not giving a report and justified “I thought I asked everyone if they’ve gotten all of their patients.”

Why this is a problem: This is classic patient abandonment: “Leaving the patient care area without giving report to a qualified person”- AZBON. This was a complex patient who had two different surgeries during this hospitalization and was also having post-op complications. Her cognition was at its baseline level -thank goodness- so I didn’t have to worry about her confusion being caused by an acute stroke, delirium, or underlying infection. However, had there been an emergency with this patient at 19:40, I may not have known enough about her to adequately intervene. Anecdotal information is a large part of patient handoff that isn’t always easily found in the medical record. A concise report from shift to shift is vital for patient safety.