Ethical question-WWYD?

Nurses General Nursing

Published

This is NOT a hw question. It is an actual thing that happened:

I might should have put it in school nurses, but this could happen anywhere I guess. A person (not a child) is having a severe allergic reaction to something they did not know they were allergic to-having trouble breathing, etc. Person does not have an epipen but a parent who has a child with a severe allergy has one one their person. 911 has been called. Nurse has to decide whether to give someone else's epi to person.

Would the nurse lose his/her license for giving the epi? Do you let the non-nurse bystander give it? Wait for 911 and hope the person lives?

I think this episode has prompted the schools to have epi on hand in case of a new onset anaphalaxis, but I thought this was interesting case.

I have to carry glucagon for my T1 son. I don't know what would happen if I gave it to someone unresponsive d/t hypoglycemia.

In this case her life was saved by a lay person a friend who gave her the epi pen she carried. Would we carry an epi pen so routinely, probably not unless our medical history demanded it. However we do not know when unknown severe allergies can occur '.....

Just food for thought.

The above is the exact reasoning why I carry an epi pen with me.

No, you don't give it, it could cost you your license very easily.

Specializes in Pedi.

The mother had EpiPen Jr? So 1/2 the dose of an adult EpiPen?

When I worked per diem in a school (high school) we had standing orders for EpiPens and several in stock. (There's a program that exists to provide them free of charge to schools, Google EpiPens 4 schools.) This was a high school, so we had all adult auto injectors since teenagers are treated with adult doses.

I think I'd give it in the situation in the OP, if the patient was clearly in trouble.

I've volunteered at a camp for children with epilepsy for years. There have been a few times when we've had to borrow Diastat from one child to give to another child. There is a doctor on site at all times at this camp, so we had the MD there who could order it and then we simply called in a prescription for Diastat for the child who'd used it after the fact and took one of the syringes from the new supply (it comes in a 2 pack) and replaced the one we'd used.

I would not attempt an emergency trach in the field. I have never been trained to perform a tracheotomy. I have been trained to administer an IM injection.

Specializes in NICU, PICU, Transport, L&D, Hospice.

If I am on my own time and encounter this situation I am going to give the med if I believe the person is going to die without it.

I would not perform a trach, however, I have been trained in cricothrotomy and would certainly attempt that if the airway was lost and death was imminent without an airway.

If I am on the job I am doing none of that but will call for the medical assistance needed in that setting to save the life of the victim. On the job I am obligated to follow the policy and procedure of the superior respondent.

No, you don't give it, it could cost you your license very easily.

And if it came down to it, you value your nursing license more than a human life?

What if that life belonged your mother, father, child....?

Specializes in ICU, LTACH, Internal Medicine.
No, you don't give it, it could cost you your license very easily.

Theoretically, touching someone without the person's consent constitutes a battery, which is a sort of crime which at least in some states leads to pretty much automatic revocation of nursing license. So I'm just wondering - would you perform CPR on a complete stranger if you don't know his/her code status and unable to get consent from the victim or someone else if doing so "could cost your license very easily"?

P.S. - I will

Specializes in Critical Care.
No, you don't give it, it could cost you your license very easily.

Sorry to pick on you since you were hardly the only one to express this view, but that is ridiculously incorrect.

Outside of a true nurse-patient relationship, the rules are bit different, but the BON will still hold you accountable for grossly negligent behavior in any setting, in other words, failing to do what is reasonable and prudent. If in your judgement someone requires an epipen injection immediately to avoid clear and imminent harm, injury or death then the reasonable and prudent thing is to give it. It's not giving it when clearly indicated that could cause you to lose your license if the BON is going to be anyway involved, all BON's prioritize the use of prudent and reasonable decisions over scope of practice issues, which technically don't even come into play here.

I can imagine the headlines: Man dies as a result of allergic reaction despite a bystander with an epipen, unfortunately for the man the bystander was a nurse".

Good Samaritan laws don't apply to us. I would give the epi if necessary. I'm in allergy/asthma so we have stock epi and many of our pts have their own EpiPen on hand. EpiPen, Jr. is for pts 33-66 pounds, EpiPen is for pts over 66#. The Epi Jr is 0.15, Epi is 0.3ml. The EpiPen, AdrenaClick, and Auvi-Q are designed for lay people to use so we can definitely use it with no problem. Yes, it might get tricky since you'd technically administer medication to a pt that wasn't ordered for that pt, but I couldn't live with myself if I didn't do what I could to save a life. Yes, most people do carry a 2-pack EpiPen, as they should, in the event both devices are needed... Whether you use one or two devices the pt is going to the ER anyway.

Specializes in Critical Care.
Good Samaritan laws don't apply to us. I would give the epi if necessary. I'm in allergy/asthma so we have stock epi and many of our pts have their own EpiPen on hand. EpiPen, Jr. is for pts 33-66 pounds, EpiPen is for pts over 66#. The Epi Jr is 0.15, Epi is 0.3ml. The EpiPen, AdrenaClick, and Auvi-Q are designed for lay people to use so we can definitely use it with no problem. Yes, it might get tricky since you'd technically administer medication to a pt that wasn't ordered for that pt, but I couldn't live with myself if I didn't do what I could to save a life. Yes, most people do carry a 2-pack EpiPen, as they should, in the event both devices are needed... Whether you use one or two devices the pt is going to the ER anyway.

Good samaritan laws don't apply to us when we are receiving monetary compensation for the care we are providing, otherwise all state good samaritan laws do actually apply to nurses. The only thing the don't protect is gross negligence, if you for some reason decided to inject the epipen into their eyeball for instance.

Good question. I don't think I would be worrying about my license if I was watching a kid descend into anaphylaxis, I'd grab the epi pen and jam it home and THEN worry about my license lol. And probably worry a lot.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
No, you don't give it, it could cost you your license very easily.

I will trade my license for the life of a child every time.

Specializes in Mental Health, Gerontology, Palliative.
No, you don't give it, it could cost you your license very easily.

And what do you think will happen if the person dies and you have the means to save them and dont use it?

+ Add a Comment