Did I participate in an unethical situation?

[defib queen]

I am worried that last week I participated in an unethical event. Here is the situation.

At our facility, we have a, usually yearly, mock disaster. At our facility it is known as a code delta. Usually it is a staged mass casualty situation such as an interstate pile-up or bus wreck. Actual participants from local high schools etc. are the "actors."

Well, last week was that time, but instead of the usual mass casualty type situation, our DES and administration thought they would be "with the current times" and have a smallpox scare, which qualifies, naturally, as a disaster. Here is the problem.

We had kind of been expecting it to go down all day because our supervisor stayed really late and just acted strangely. Our ER was completely full, hallway beds too. A full arrest had just come in, a 55yo breast ca pt, we worked her for 45 minutes to no avail. The family was taking it really hard, especially the daughter. I had been in the resus. room with the family for 30 min. or longer trying to calm her and then stepped out to call organ donor people, which in our state is mandatory on all deaths, and get the death certificate going. The triage nurse had stepped off the unit for a moment when two people came to the triage window with dots painted on their faces and hands. Needless to say, I had the priviledge of triaging them. Our resus. room is also the resp. isolation room in our er. Our supervisor made us clear out a sick person from another room to the hallway, place the body and grieving family into it, and place the two actors in the resus. room. I was so angry about doing that that I had to leave the er and cry for 15 minutes before I could go back and face the family and my co-workers ( who also thought this sucked, however the family did not find out why their mother was moved to a smaller room on the other side of the er). Had this been a real situation or similar need for the room I totally would not have had a problem, as it was, I feel that what we did was cruel to the family and unethical. Am I wrong about this?

[ERQueen]

We usually move a deceased patient to an unused non-cardiac/respiratory...whatever...room before we bring the family in. This gives us a chance to make the patient look as presentable as possible, even if we can't remove tubes. This also usually prevents a situation like the one you described. We've never had to move a patient out of their room for "fake" patients, but we sure have had to run people out into the hall so we could use their room for real patients.

During our disaster drills (we usually have at least 2 per year), we designate our fast track area for disaster patients. We simply assume that if the real thing were to occur, and it was a true disaster, we'd be sticking people in the coffee room if we had to. I mean, what are you going to do....pile all of your "Disaster" respiratory patients in your one isolation room?!?

As for the lawsuit.....you can sue for anything, but it's not a very good chance you'd win, and if you did, it probably wouldn't be enough to make it worth all that effort? I mean, our legal system sucks, and it takes too much of a headache to sue just because you are upset.

[l.rae]

Originally posted by Sleepyeyes

Does your hospital have an ethics committee? maybe this would be a good topic to establish a new policy on?

my thoughts too...ethics commitee should surely hear about this.

[DIPLOMATICRN4HIRE, MSN, RN]

This was the most disgusting ,inappropriate, thoughtless, disrespectful,and careless actions I have ever seen. Yes I would go to the ethics committee ,I would tell them how horrible it was to remove a REAL LIFE TRAUMA AND TRAGIC event to the family and to replace it with a IMPROV. It disrupted the grieving process of the family. Which is something they will recall when they DO find out about the MOCK Delta, and they will know that they were moved and who was put in the room where their mother just died. Dont you think the lil red dots on the faces of the walking people would be a clue. Dont assume they didnt see it. Dont assume they wont take action as well.

I would be so offended that you (administration) felt the need to play act was more important than allowing the grieving process of a human being, and disturbing the process is nothing but blatent ignorance and disrequard of the patient and the family

I am so sorry that you had this happen, you were an bystander in this moronic display.

Just my thoughts

Zoe

[RN2B2005]

Yup. I would have to go with the "WTF" crowd on this one.

At the hospital I worked at in a non-nursing capacity, they DID have drills...but there were memos out the day before, precisely to AVOID the endangerment or inconveniencing of ACTUAL patients. The hospital 'encouraged' participation by disciplining staff members found to be non-participants in the drill (unless we had a direct patient responsibility at the time of the drill) and by rewarding staff members with treats (candy, cookies, small things) at the end of the drill.

On a similar tangent, I read today in the NY Times that more than a few state and local public health agencies are cutting services considered 'non-essential' like Pap smears and children's dental care in order to pay for smallpox and bioterror drills and preparation. Sure, those patients will appreciate all that preparation some day, if someone does manage to produce smallpox...or rather, those patients who are still ALIVE, some having died from undetected cervical cancer in the interim.

[Really An Actress]

I never thought mock disasters should be a surprize to health care workers. By not allowing them to anticipate their roles, they end up making more mistakes. I think it's better to know what day the drill will occur so nurses can do some mental rehearsal and they can focus on getting things right instead of having so many mistakes to go over in the review.

And, most definitely, a manager who is there after hours is a sure sign that something is up,lol.

[Keysnurse2008]

OMG...how awful!!!!! Examples like this make me sick...this shows how Nsg Administration has lost sight of the complete picture!!! When will they "realize" that these are patients...people .....families....we are dealing with. That family...left your facility...and no doubt lost sight of the excellent care they recieved from the nsg staff and physicians.....simply bc of a BS "ED TRIAGE casulty drill???? I must add mine too....WTF?

[hipab4hands]

You really need to notify some one in upper management, so that they are aware of what happened. I wouldn't present it as the "blame game" on the supervisor, but upper management needs to have some contingency plan, so that this situation never happens again.

[Keysnurse2008]

You really need to notify some one in upper management, so that they are aware of what happened. I wouldn't present it as the "blame game" on the supervisor, but upper management needs to have some contingency plan, so that this situation never happens again.

well said.....I mean....these are families...people.....who have had a traumatic event....a huge loss for their family. Now they see "momma" shoved ina coat closet...meanwhile this whole fiasco is going on around them.It is an outrage...as I said .....the excellent care the patient and their family had received prior to that...I am sure was now overshadowed...and they probably left feeling that their loss was very very unimportant.It is wrong...and just sad.I am so sorry this happened to you...it overshadowed all the wonderful care I am sure you had given to this family in their time of loss.sad....

[following_faith]

Wow...:angryfire I am sorry you had to go through this!

People should be required to work at least so many years as a healthcare worker out there in the trenches before being able to make decisions from the ivory tower.

[Marylou1102]

How incredibly sad for both you and the family.

[SmilingBluEyes]

Please note this thread is nearly 4 years old and the OP unlikely to reply.

If the OP is still around, I would love an update, however.

An answer to your question is:

Yes it was unethical.

[NurCrystal22]

Um, I think it's really messed up you had to do that.... WTF?