You can not determine the acuity of the patients until you have received report and then you make a determination to accept that patient. Clocking in is just that, you have clocked in to start your shift. Even after you receive report if you decide that the total assignment is or that one particular patient is above your scope of practice or you skill level, you would then inform your charge nurse and the nursing supervisor of the situation. It is not patient abandonment to do this. It is if you walk out of the building and have not attempted to inform them.