Refusal for Blood Draw - page 2

We had a pt come in about a week ago who had been involved in an MVC. The pt was awake and oriented. The cops told us to draw blood for their kit but the pt refused to have their blood drawn. The... Read More

  1. by   TazziRN
    We need a consent before drawing a legal blood unless the pt is a minor in custody.

    Years ago, as a new nurse, I had a drunk pt come in from an MVA. He was so drunk he was almost obtunded. I stood there and watched the cop hold a pen in the pt's hand and scrawl a "signature" on the consent form. To this day I feel guilty for allowing that blood to be drawn.
  2. by   Jabramac
    Had a similar situation. Pt refused blood draw, the MD became the responsible person for this situation then, not the RN. The MD decided the pt was compitent, not intoxicated and had a right to refuse. The cop needed to get a court order, of which I don't think he was happy about because a pissing match ensued, and the result was the cop arrested the MD and hauled him to jail for abstructing justice, even though a judge had already been paged and they were waiting for a call back.

    Eventually a court order was obtained and with the court order the pt cooperated with the draw.

    In the end all charges were thrown out and nothing came of it, except that the MD was hauled to jail and had to go through the booking process. Ultimetly in my state the MD was right, but the cop didn't like that.
  3. by   Jabramac
    Quote from MLOS
    I have to disagree here ... the situation depends on the laws of the particular state. In my state, a refusal to allow a legal blood draw when the officer suspects impairment is the same as a guilty plea. In other words, yes, you can refuse to allow the blood draw, but the case then proceeds as though you've pled guilty. This is explained to offenders as part of the arrest.
    We had a situation once with a murder where the pt was refusing, the cops explained that if his blood alcohol was low or .0 he would likely have more ramifications, but if his blood alcohol was high he might get off easier on the basis of being intoxicated when it happened. He knew if he refused he could later on actually claim to have been more intoxicated then he really was.
  4. by   morte
    Quote from Jabramac
    Had a similar situation. Pt refused blood draw, the MD became the responsible person for this situation then, not the RN. The MD decided the pt was compitent, not intoxicated and had a right to refuse. The cop needed to get a court order, of which I don't think he was happy about because a pissing match ensued, and the result was the cop arrested the MD and hauled him to jail for abstructing justice, even though a judge had already been paged and they were waiting for a call back.

    Eventually a court order was obtained and with the court order the pt cooperated with the draw.

    In the end all charges were thrown out and nothing came of it, except that the MD was hauled to jail and had to go through the booking process. Ultimetly in my state the MD was right, but the cop didn't like that.
    did the md persue false arrest/imprisonment charges against the cop? if he didnt, he allowed a bad cop to continue to work...and did the other cops no favor....
  5. by   KellieNurse06
    wow...I can prety much bet this cop is a power tripper abusing his authority....My bf of 9 yrs is a police sargeant on our local pd and I am going to ask him when he gets up.....I can pretty much bet he will laugh at this.....I think they'd have to get a judge to give an order to draw the blood........I know in my state if you refuse the breathalizer you automatically are guilty and you lose your license for a while...I actually think the law just changed and it's a few years now that you'd lose your license..... anyway I am curious so now I am going to ask him when he is up this morning...I'll let you know what they do where he works.........
  6. by   Noryn
    See in a perfect world you wouldnt get in trouble for doing the right thing but as we all know the world of nursing is far from perfect. I too have heard of nurses being threatened to be charged with obstruction of justice. You really have to choose between the lesser of the two evils. If you dont do it, there is a chance you can get arrested for obstruction of justice. Noone wants to be arrested but being arrested doesnt necessarily mean you have done anything wrong and I dont think the obstruction charge would stick. For instance I can call the cops right now and tell them my neighbor hit me yesterday. The neighbor would be arrested regardless of them actually being innocent. Then I could be in trouble for filing a false police report.

    That is why I told you to refer the headache to your supervisors and let them deal with this mess. Like I said above, you have to also look at the worst case scenarios. One you can get arrested and the charge will likely be dropped. On the other hand if reported to the board you can get reprimanded and also get arrested if the pt files a charge of battery on you for doing this against their will.

    In nursing a lot of times we get in trouble for doing the right thing. This is just another example of the bs we have to put up with at times. If all else fails and you are soley placed in this situation and noone including administration or the doctor will help you and the cop is going to actually arrest you for not drawing blood just fake a sudden illness.
  7. by   oramar
    Quote from morte
    did the md persue false arrest/imprisonment charges against the cop? if he didnt, he allowed a bad cop to continue to work...and did the other cops no favor....
    My thought also. So when do you get the right to abuse a nurse or doctor because some jerk decides to drive drunk? A case like this could easily result in a law suit against the city that hired the cop as well as the cop.
  8. by   Northernlights
    In the state of WI we have an implied consent law which states that drivers have implied that they give consent for chemical testing when they receive their licenses. However WI also has a law protecting professionals that do blood draws saying that they do not have criminal or civil liability when they draw blood in such cases except for criminal negligence in the act. Our facility has two different forms which are used: one for a patient who gives consent and one for a patient that refuses to consent. In both cases the officer fills out a section which cites the law used to demand a sample. In our state if the driver has already had one DUI offense or if there is an accident with fatality, the blood draw is mandatory.
    I disagree with the poster who want to make a legal blood draw wait for many hours before drawing them. In some cases if the draw is done more than 3 hours after an incident it is inadmissable as evidence.
    We all see the devastating effects of alcohol and driving. As nurses we should be willing to assist law enforcement to curb this problem. ER managers and law enforcement should work together to educate ER staff in their role.
    Northernlights
  9. by   Noryn
    See this is one of those areas where there are ethical concerns. I wonder if the WI state board of nursing has a position on this? Doesnt this go against our code of ethics allowing the pt to choose or refuse treatment as long as they are competent? While laws are important, they are not the final word especially in regards to nursing practice. Participate as a RN in a legal execution and see how fast you get called to the board.

    I only said I would make them wait if they got to the point where they were threatening on a regular basis. The simple fact is that obtaining an ETOH level is not a life or death emergency and often I was taking care of patients who had a life threatening emergency. My feelings go deeper though that this post, I just cant understand how the ER is responsible for this mess since it really isnt an emergency. Every ER I have been in is a zoo, right now the wait time at my local ER can approx 8+ hours in the waiting room. I know the horrible effects of drunk driving but I am in the business of taking care of people including the "drunks" who are injured.

    It just touches a sore point for me, because as an ER nurse I just didnt have the time nor the desire to force treatment on someone especially someone who was inebriated if it wasnt a life or death situation. Attempting to restrain those patients puts undue risk of harm to the caregivers not only direct physical harm but also needlestick injuries.

    Dont blame me for drunk drivers, if anything make the penalty for refusing to have this drawn much harsher.
  10. by   33-weeker
    All this legal stuff hindering nurses & cops is just nonsense. It's a urine spec. or a little needle stick - get over it!

    If a person is caught driving appearing obviously impaired, then they should be able to be tested for ETOH & drugs. If they haven't broken the law, then they have nothing to hide. If they have broken the law, then they need to get caught. Especially if they were involved in an accident.

    If they turn out to be 'clean' and impaired, then the ER is where they need to be because something is definitely wrong with them.
  11. by   canoehead
    Why don't they just take a urine sample? That would eliminate the wait for someone to draw the blood.
  12. by   Noryn
    Quote from canoehead
    Why don't they just take a urine sample? That would eliminate the wait for someone to draw the blood.
    I dont know if a urine drug screen would hold up in court. There are too many variables involved along with false positives but when you are dealing with alcohol most laws specify a blood alcohol level as a sign of intoxication so it pretty much has to be blood drawn.
  13. by   clee1
    Quote from Northernlights
    In some cases if the draw is done more than 3 hours after an incident it is inadmissable as evidence.
    We all see the devastating effects of alcohol and driving. As nurses we should be willing to assist law enforcement to curb this problem. ER managers and law enforcement should work together to educate ER staff in their role.
    Northernlights
    Sorry, friend.

    I went to school to be a nurse, the ethics of which require that I advocate for my patient.

    It is NOT my job to gather evidence for the government; I don't work for them. If ever presented with a court order and the pt still refuses the draw, somebody else will have to obtain the specimen.

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