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?

[Stargazer]

"Undue pain & suffering and intentional infliction of emotional distress" + Hospital corporation/deep pockets + greedy lawyer = lawsuit.

We live in a very litigious society.

[defib queen]

First, I must clarify something. It was not a matter of moving a deceased pt from one place to another. The er was full, hallway beds included, there were approx. 15 pt's and visitors in the hallway between the two rooms, there was nothing discreet about moving the body, especially when someone was on the PA calling out code delta level one three times very excitedly and seeing shocked looks on staff faces who were unaware of the mock nature of the code. None of the staff were supposed to know about it, however neither were we stupid. sudden posting of smallpox info+instuctions on what to do+supervisor staying very late=mock code, duh. Afterthought, I should have gotten a washcloth out and wiped the dots of their faces and asked what they had been huffing and stopped the whole thing in its tracks. My real beef is that if it was a mock thing, why couldn't we have a mock resp. isolation room, and not wasted valuable time away from real sick people i.e. moving out the sick pt to the hallway which was already full, just to move a body so we could make a place for two actors who had not one thing wrong (except their acting skills). I probably did overreact a little, I was exhausted and a little more sensitive than usual, however, I felt that we paraded a families grief unnecessarily.

[Pretzlgl]

I agree with you defib - totally inappropriate! For those of you who think it wasn't a problem, ask yourself this...If it was your mother who just passed away - how would you feel if you knew what was going on? And please don't try to say it wouldn't matter, because you KNOW it would. Yes, the family's grief probably prevented them from realizing what was happening - does that make it right? The need for mock drills is there - but like defib said, there could have been a "mock" iso room also.

[renerian, BSN, RN]

I think I would have refused to do it but hey I am quite stubborn and protective of my clients. Hard to do though.

renerian

[CMERN]

MY OPINION.... THe families death of a loved one was REAL!...The Code Delta was play like...Why couldnt D**mned administration "play like" another room was an isolation room..GEEZ..I dont know about unethical but it was definately COLD and UNCARING and SOOOOOOOOOO uneccassary to inconvenience a family in the way that it was done....Good GRIEF!!!!

[Youda]

I guess I don't understand the purpose of putting fake patients into a real working ER with patients in the halls. The topic of the thread is the grieving family, but what about all the LIVE patients in an over-loaded ER whose needs are delayed or missed because the nurses are dealing with some kids with dots on their foreheads?

When I've been in mock codes, mock whatever, we also have used mock "real" patients, so that real bonafide patients aren't anywhere around! There are mock drills going on all over the country right now, but it seems your admin is certainly risking a lawsuit! Not from the grieving family, but have one burst appendix die in the hall while you all are playing around with mock patients, and all heck will break loose.

The admin needs to open a few rooms in the basement for mock drills far away from real patients.

[Sleepyeyes]

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

[KC CHICK]

Completely inappropriate.

Would your department manager like her family to be treated that way? IMO, it was absolutely NOT necessary to conduct a drill at that time. Would have been totally understandable to all involved had it been REAL. Reality check (for all devil's advocates)...This was not real...it was a FAKE drill involving actors. REAL PEOPLE were greiving for the loss of their family member...not actors.

What's next, an anthrax drill during a trauma? How about a fake bomb threat drill during a code? Come on, people...use your heads. Treat the real problems first and foremost, then worry about playing drill games.

Someone had their head up their patootie on this one.

Anne:confused:

[tattooednursie, LVN]

ditto! and WTF! That is wrong, but it aint your fault!!! The shouldnt have had the "play" in the real ER! and if they wanted the "real scenatrio" in the ER they need to work around the REAL stuff going on! That family is first priority!!! They lost their mother for heaven sake! If it was a real situation it would have been different, and it would have been ok! but this wasnt real, so they should have waited.

[hapeewendy]

wow I'm too upset to write anything except DITTO's to what most ppl have said already...

that was freakin ridiculous!

mock disaster is one thing, real patient needs are another.......

if it was a real disaster scenario no doubt people could figure out where to put the deceased patient, I mean it would be chaotic but thats the nature of disasters

to move this patient when its a mock disaster was an awful and WRONG thing to do.....

someone better help us all if in the name of a mock disaster real patient needs get sacrificed and ignored

heavy sigh

[zudy]

I'm not a bit surprized. This whole situation is completely typical of the administrators that run our hositals. They have no concern for our pts, the families, and especially for us, the people that care for them. All that matters to them is that they can say that they had the drill that was required, all of their precious paperwork is done, and they once again sit on their lazy butts, and make more money that we ever will for doing nothing. ( oh golly, do I sound bitter?) I've said it before, the only thing that keeps me going is the knowledge that there is a special place in hell for these people.

[nimbex, RN]

hey, here at fort brag, we do participate too! I do not work ER so my heat goes out to you, I am in the ICU, which diverts RN's to the ER, so like you, our patients go without, for a happ-hazzard what if.....

but please remember... when the "what if happens", you'll know that you'll need to move that family, just as you did, which is why the drill occurrs. My heart goes out to that poor family and to you too,