What do you need to know?
Nurses often ask if refusing an assignment or withdrawing care would be client abandonment (see Duty to Provide Care Practice Standard). The answer depends on whether you have accepted an assignment or established a relationship with the client. If you have done so, you are abandoning your client if you stop providing services or care without:
- arranging for another appropriate care provider to take over,
- giving your employer a reasonable opportunity to find a replacement, or
- ending your services in a way that is acceptable to both you and the client.
Situations which could be considered client abandonment:
- Leaving in the middle of a scheduled shift without notifying your supervisor and without transferring care to another appropriate care provider.
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Leaving your unit for personal reasons and being absent for long enough that client care could be compromised.
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Being unavailable to other care providers or not providing care yourself because you are distracted by personal activities (e.g. sleeping, on Facebook, playing computer games or making personal phone calls/texting).
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Refusing to care for a client after accepting responsibility without transferring care to another nurse or allowing your manager a chance to find a replacement.
Situations which are not likely to be considered abandonment:
- Refusing to work extra hours or shifts beyond the posted work schedule when you’ve given proper notice.
- Refusing to accept an assignment when you’ve given reasonable notice to the appropriate person that you aren’t competent to carry out the assignment.
- Resigning from employment without giving notice.
- Refusing to float to an unfamiliar practice area without preparation or orientation and an appropriately modified assignment.
There are times when it may be acceptable for you to withdraw from or refuse to provide care. Such times would include situations that put you, or your clients, at an unacceptable level of risk.
Many factors can hinder your ability to provide safe care (e.g. inadequate resources, unreasonable expectations, or the level of competence needed). The Duty to Provide Care Practice Standard can help you decide what to do in these situations.