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Press Start: Lead an Empowered Life as a Clinical Laboratorian

What Qualifies as Patient Abandonment?

Published December 27, 2007 5:04 PM by Glen McDaniel

A few weeks ago, I wrote a blog discussing the relationship between low pay and female-dominated professions

As is typical with blogs, the subsequent discussion from readers touched on several indirect subjects including nurse/patient ratios. Bernd from New York then mentioned the concept of patient abandonment and referenced the New York State situation regarding patient abandonment.

That particular point got me thinking about the abandonment concept. As a hospital COO, periodically I heard charges of patient abandonment hurled at nurses by other nurses. In the profession, abandonment is considered the crudest, most unprofessional act. After all, nursing is supposed to be about caring and always making the patient No. 1. 

While some cases could be conceivably considered abandonment, in most instances, the accusations were just empty charges designed to embarrass and malign a colleague. In nursing, abandonment ranks right up there with sexual harassment and patient abuse. Stay with me here, this is convoluted, but I am getting to the point.

Although clinical laboratorians do not have individual patients, they certainly work for the good of patients and perform an essential role that impacts on life and death. Should there be a similar concept in the CLS profession? Are there instances in which laboratorians can be credibly accused of job/patient abandonment? What sorts of actions would qualify?

Some scenarios: A Microbiology CLS is pulled to Transfusion Services to help because of several traumas in the ED. When the sole TS tech repeatedly asks her to perform tasks she is uncomfortable doing, the Microbiology tech leaves rather than (in her words) "kill somebody."  

A CLS/CLT who has worked a double shift leaves when his/her relief does not show up on time. What about if there is a bomb threat in another part of the hospital and a CLT leaves the hospital against her supervisor's instructions because she thinks self-preservation is the first law?

posted by Glen McDaniel


Emmet: you quite rightly addressed the potentially negative impact on patient care created by practices such as releasing results when quality control data suggests a problem with accuracy and/or precision. In fact QC is routinely conducted to prevent precisely this sort of problem.

It's interesting that you mention "co-worker abandonment". One reason I wrote this blog is that laboratorians tend to think of relationships within the lab without looking fully at implications OUTSIDE the lab.  Producing shoddy work in the lab is similar to a nurse being late with medication, giving meds to the wrong patient, doing an incorrect intervention, not properly assesing a patient etc. Certainly the patient is not adequately served. Patient abandonment in nursing means actually leaving your post or not showing up-in effect "abandoning" your patient.

I wanted to suggest we go above turning out perfectly-controlled results  and consider the consequences patient-wise if a laboratorian is deliberately absent or otherwise neglects his or her duties. It's certainly annoying to colleagues, but what's the effect on patients?

if the patient is our ultimate raison d'etre, what's our obligation to being there for them, not just our colleagues?

Glen McDaniel January 9, 2008 3:12 PM
Atlanta GA

Your examples sound more like co-worker abandonment  than patient mistreatment.  Even so, there are implications for the quality of the work and effectiveness of the Laboratory.   Problems like this cannot be ignored but they take an excessive amount of time to turnaround.   A successful manager will replace, remove or restructure work-relationships before they decay to this level.

In terms of patient abandonment, the most straightforward example in the lab is failure to take reasonable and appropriate action when quality control data indicates a problem or failure.  

Emmet, Laboratory Medicine - Lab Manager, MCDH January 8, 2008 1:03 AM
Fort Bragg CA

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