This happened to me this week.
A hospice pt. comes in to the ER. He has end-stage renal cancer and is here for a PCA morphine pump and a Kayexalate enema. (good hopice huh). So the guy is pale as a ghost and hallucinating, I can't get an accurate O2 but it's somewhere around 75%. His BP is 82/40 his family is very rude and demanding. The Dr. comes in and tells me to give him 5 mg of morphine, repeat it until pain is under control, then takes him off the monitor. Another nurse tells him we have to take his vitals if giving morphine. Dr. says--well, new rules.
What would you do? I'll tell you later what I did.
still a student here but if the doctor is telling you to go against protocol, I would refuse and go up the chain of command. I wouldn't risk my license because a doctor decided to suddenly change the rules.
EDIT amending post to clarify that I didn't mean holding the meds, I meant as far as doing the vitals. If the doc said not to follow protocol on vitals, then I would go up the chain of command--which would be the NM I guess. (I am interested to read the posts to this; I worry about facing an ethical dilemma myself someday)
Last edit by MIA-RN1 on Jan 12, '06