I don't want to give too many details for pt privacy reasons. We had an ECF pt sent to the ER a few nights ago, the nurse calling report said the pt. had sustained a minor injury in a fall. A&Ox4 , late 80's, full code. When she arrived by private squad aprx 40 minutes later she wasn't breathing, had no pulse and CPR was initiated after her arrival to the ER. After intubation and about 3-4 rounds of drugs, no response except an unsustained burst of V-tach before asystole again. Resident MD starts ordering a bunch of crap, XR, blood gasses..you know the routine. Meanwhile, the pt is purple up to her breasts. One of the nurses said to the resident, "no way we need all these tests, she's gone and this just runs up a huge bill for the hospital and the family." Then Dr. Bright-Idea wants to know if we can get an ultrasound...uh no. A few more rounds of drugs, pt is very purple, probably disected the aorta. Anyway, I say to the resident, "even if you save her you are doing her and her family a huge disservice, she is purple to her breasts and no way is she going to have a ny quality of life if you COULD save her." He glares at me and says ..."We'er practicing!! OK?" I nearly shout back at him telling him that is totally unethical. You could have heard a pin drop for about a split second. Then he says, "well, she is a full code, I have to tell her family I did everything I could to save her." I said to him that coding a pt for practice when there is no hope of survival is not ethical. He says he will run the code "till I say stop, if you don't like ityou can leave, this code is going on with or without you.."
I say ,"well I don't like it." About that time a PA walks in and asks if she can do anything. I say "Yeah, take my place," and I left.
I was later told that he ran that code a good 5 minutes more out of spite. Even the PA was livid and she wasn't even in there for the worst of it. The PA, the other 2 nurses and the RT have all said they will back me if I go to the ethics committee. I am waiting to talk to my NM first, she has been out of town and I want to give her a heads up on this. Plus, I have never gone to this committe before and don't know what to expect.
My fears are that he can cause hard feelings between me and the other ER docs, it's a good old boys club, and though I like our docs, I don't know how they would react to me turning in one of their own. AND, she was a full code, so that will be the loop hole he will probably squeeze his slimey ass through. BUT, he did say in a room full of wittnesses that he was practicing. hmmm?
About an hour after this happened he apologized to me, but he still doesn't think he did anything wrong as far as the code situation. I told him if that were my family member and I found out what he was doing, I would sue him. YIP, looked him straight in the eye and said it. He was nice the rest of the shift, but I still wanted to twist his balls off.
I just don't know I will do next... what would you do?
Good for you. I would be upset too. I hope you did report it, and that the fellow code members supported you. I know the dr's need this practice, but this wasn't the right situation. I too would sue if it were my family member and I knew what really went on. Please keep us posted on what happened ok? :)
My fears are that he can cause hard feelings between me and the other ER docs, it's a good old boys club, and though I like our docs, I don't know how they would react to me turning in one of their own. AND, she was a full code, so that will be the loop hole he will probably squeeze his slimey ass through.
Here is what I would do: protect MYSELF.
Talk to your NM and tell her what went on. He's a resident and we all know what they're like; we also know about the good old boys club.
I would protect my job and not worry about getting back at this resident or trying to "see justice done." It's too late for justice, it was gone when he coded her for five minutes or more.
If he apologized, HOPEFULLY he saw the error of his ways. Perhaps he REALIZES how ludicrous his statement sounded....I would definitely talk with him again and make SURE that he realizes that what he did is not acceptable.
soniblvn
33 Posts
Good for you. I would be upset too. I hope you did report it, and that the fellow code members supported you. I know the dr's need this practice, but this wasn't the right situation. I too would sue if it were my family member and I knew what really went on. Please keep us posted on what happened ok? :)