What if you know a doctor made a mistake?

It sounds as if the baby was very sick, as you said that the bleed could be questionably caused by the medication, leading me to believe that the baby could have had a bleed despite administering the medication. Most hospital risk management teams investigate these cases whether incident reports were filled out or not, you or your nurse manager may not even know it is being investigated. Was it documented that the med was given by the doctor? Did the doctor write an order for the medication? Was the medication contraindicated in this patient?? If you feel so uncomfortable, I would ask that doctor why she gave the medication, what was the indication? If you still do not feel comfortable with that, I would let your nurse manager know your feelings, and back it up with research, she can help you decide whether an incident report should be completed or not. Good luck, remember you are your patient's advocate.

I'm a student, but I have seen a similar situation occur where a medication was contraindicated and the physician insisted on the administration.

I think a couple of things went wrong. First, the nurses should have refused to give it. Second, if the physician was going to administer the drug directly, then the charge nurse should have been notified upon discovery and sent it up the chain of command.

At our hospital, unless it's a life threatening emergency, once the charge nurse starts to take the complaint up the chain, the physician cannot proceed. Usually an answer comes from "upstairs" within a 2 to 3 hours and usually comes down from the Chief of that department.

This is the process that was followed when the nurses were faced with this at the hospital. He had four nurses that just looked at him and said, "No way. My name is not going to be attached to that."

Sometimes the nurses DO know better and anytime you are in the minority opinion, physician or not, if I was one, I would be a minimum, conferring with another physician to make sure I didn't get laid out on the lawsuit platter.

Fill out an incident report and/or discuss it with your manager/supervisor. It is not your place or responsibility to notify the family, as this is potentially a lawsuit waiting to happen. It should be taken to through the proper channels as outlined in your facility's policies and procedures.

Fill out an incident report. The family may already have an attorney looking into possible damage. They don't have to prove that the medication caused the damage, just that it may have contributed.
A lawsuit on the child's behalf may not be filed for years.
I would keep a copy of the incident report (black out identifying data).
Does this Doctor have a history of idiocy?
Don't compromise your integrity. Nothing wrong with having a friend drop a dime anonymously from a payphone to the family, if you feel that is what is best for the child.
The child comes first.
I disagree that it is not your place to notify the family, if that is what you feel is right. Just because someone puts a policy on paper doesn't always make it ethically right. Sometimes, it all depends on the situation.
Policies and procedures are utilized at times to allow us to assuage our guilt- by giving us a way to pass the buck onto our so called superiors.
Do whatever is right for the child.