Doctor on the edge of ethical behaviour.....

UM Review RN, ASN, RN · Jan 12, 2006

The dr. denied having given the pt. anything before that and tried to BS his way out of the situation by explaining that he was just curious to see what effect the epenephrine would have on this pt.????????
I guess my question is, what would an american nurse do about this situation? And has anybody ever seen this kind of behaviour?

This extremely unethical behaviour (which goes along the lines of experimentation on a patient without informed consent in the US, since it does not follow approved guidelines for treatment of a condition or a disease) would be reported, and the physician would lose his hospital privileges, if not his license.

A nurse who witnessed would be mandated to report or she could potentially lose her job and her nursing license.

The patient and/or family could file a lawsuit against the hospital, the doctor, and the nurse.

Very, Very Bad all around.

grannynurse FNP student · Jan 12, 2006

I was just wondering if anybody has ever had this kind of experience....I've been a nurse for 10 years in Germany, and this is the first time that anything like this has ever happened.....
We had a really sick pt. on our ICU unit who has been receiving therapy for the last 3 weeks even though his case was pretty much hopeless....
After many days of consulting with his family and the courts, it was finally decided to discontinue treatment.
During my nightshift, it became apparent that this pt. was not going to make it through the night. The Doctor on duty (we have one on the unit 24/7) got really funky about the whole situation. My co-workers and myself didn't think much of it until all of a sudden, this pt. who up to then, had a blood pressure of only 80/40 and a SaO2 of 65% suddenly shot up to 140/90 with a MAP of 100! We weren't really sure what had happened, since we hadn't actively done anything to this pt. such as turning him, or giving him any meds. It took a few minutes, and then the blood pressure was back to what had been "normal" for this pt.
About an hour later, I was walking by this patients room, (who, by the way, was not my pt. that night) on my way to see to another pt. when I saw the dr. leaning over the pt. doing something to his central line. Immediately, the blood pressure started going up. I grabbed the nurse who was responsible for the pt. and we confronted the dr. who tried to hide something behind his back. It was a syringe filled with epinephrine! I couldn't believe it! :angryfire The dr. denied having given the pt. anything before that and tried to BS his way out of the situation by explaining that he was just curious to see what effect the epenephrine would have on this pt.????????
I guess my question is, what would an american nurse do about this situation? And has anybody ever seen this kind of behaviour?

What this physician did would be at best assault and battery, here in my state, Florida. It also sounds like your facility made this patient a DNR-Do Not Resuscitate. Giving him anything, by the physician, to support or prolong his life, is at best an ethical violation and would be reported to the facility and appropriate state agencies. I do have a question, how did you know it was epinephrine? Did he state it? If he did, you need to report it, in writing to your facility's administration.

Grannynurse

kersti · Jan 12, 2006

We keep different emergency medications on hand that are counted and controlled daily. This dr. was stupid enough to take one of these- so it was easy to figure out what was missing from the depot.

nhelkhound · Jan 12, 2006

Good Lord, a nut is running the asylum! Please document and report this dr.'s unethical behavior ASAP!

kersti · Jan 12, 2006

Like I mentioned, I have been a nurse for over 10 years in different settings, and have never, ever, seen this kind of behaviour before....I am still in shock over it and a bit numb. I don't think it should be generalised as a problem in Germany, though, because of this one incident. It was an extremely misguided, awful action committed by one individual, regardless of what nationality he is.

TazziRN, RN · Jan 12, 2006

You need to report him asap. There are a multitude of things he did wrong here which all boil down to assault and battery.

Saoudishabiba · Jan 12, 2006

As above posters have said: REPORT! REPORT! REPORT! If you are a witness to the activity and you don't report it, then you are just as responsible as this physician.

Cover your own butt. You work too hard for a nursing license to let an unethical doc take them from you.

prmenrs, RN · Jan 12, 2006

I glad someone caught him. And terrific that those meds are controlled so you knew which one he used.

Have you discussed it (officially) w/management or other authorities?

amnesia · Jan 13, 2006

Soooooo... Scary!

steelcityrn, RN · Jan 13, 2006

What strikes me as odd about this is why would a Dr not know the effects of that medication anyways? Why would he risk so much to know so little?

froghair · Jan 13, 2006

very bad situation and when it comes down to it it is your word against his and management will always take the word of a dr over a nurse. you need to talk to the nursing supervisor or rn incharge of the ward and take it from there. although the problem is about what the dr did it could come back to bite you on the orifice, sounds stupid but it could