Nurse Wubbels Stands Tall

jeastridge, BSN, RN

"University of Utah Health supports Nurse Wubbels and her decision to focus first and foremost on the care and well-being of her patient," said Suzanne Winchester, the hospital's media relations manager. "She followed procedures and protocols in this matter and was acting in her patient's best interest. We have worked with our law enforcement partners on this issue to ensure an appropriate process for moving forward."

The above statement concerned a saga which took place on July 26 when nurse Alex Wubbels was placed in handcuffs and left sitting in a hot squad car for 20 minutes before being released. The confrontation was precipitated by a police officer's request to draw blood on an unconscious patient without a warrant or consent. Video of the encounter was recently released and brought the issues at hand to the forefront.

Formerly a member of the U.S. Alpine Ski Team, Wubbels (competing under last name Shaffer) participated in two Olympics before becoming a nurse. Working in the Emergency Room, she was on duty when the patient in question was transported after a collision. The detective working the case insisted on drawing blood and nurse Wubbels advised him of the need for a warrant. In the video that was released, we see the officer's body cam recording of Wubbels showing him the written policy while having her administrator on speaker phone.

In April 2013, the Supreme Court ruled that a warrant is required for a blood draw during drunken-driving investigations and that the dissipation time for alcohol alone is not grounds for violating this requirement. Wubbels was simply reiterating the policy of the institution where she is employed and her comments were witnessed by her supervisor/administrator who also corroborated her stance over speaker phone.

What can we learn from this clash in Utah?

The patient is always #1

Advocating for a patient's rights as best we know them, is part of the nurse's responsibility and mission. This particular case is an extreme manifestation of taking a patient's side and doing what is right according to the law as it is understood. But daily, we nurses do little things that protect and help those in our care-putting up that "do not visit" sign or talking with family members or visitors who are causing the patient distress-these are all every day examples of how we take our duty as nurses to heart. In training we learn that one of our truest roles is to be a patient advocate and to put the patients' needs first. In day to day nursing we sometimes find that covering an unwanted shift or staying late until help arrives is less fun than it is noble. Duty, discipline and emotional maturity often separate a nurse who is "just doing her job" from a professional.

What the patient might have done does not affect the quality of care

We are nurses, not judges. We are professionals that provide excellent care regardless of the patient's background, color, immigration status, religion, criminal background. Whether they are the Mother Teresa or someone on the other extreme, we are not called to make assessments of their worthiness prior to delivering care. We are, instead, called to excellence in every and all situations to the best of our abilities.

Know the policy of your institution

While we are inundated by policy manuals and procedures, it is imperative that we at least know exactly where to find these policies at a moment's notice, should the need arise. I can remember in school having an instructor tell us that we didn't have to know and remember everything but "By golly! You have to know how to find it!"

Have your supervisor on speed dial

Especially if you work in a high energy, fast-paced environment such as an ED

In the military they often talk about the chain of command. While we don't have that particular nomenclature in civilian life, the principle it establishes is the same. It is a good idea for all of us to get familiar with our superiors, work to establish good relationships with them, and know how to reach them in a crisis situation, and how to deploy their help. Nurse Wubbels set a good example by having her superior participate in the interaction via cell phone. Technology can be a real asset.

Maintain a calm demeanor

Don't stoop to the level of the aggressive party. Wubbels did an admirable job of answering the officer's request: she showed him the actual policy and she had her supervisor on the phone to witness the exchange. Her professionalism is a credit to the profession and something we want to encourage in one another. Sometimes training in disaster response and in de-escalation of conflict can help us through these intense times. Rehearsing appropriate responses-just like doing CPR training over and over-can make a clear-headed response more likely. When our knee-jerk response is to yell back, we have to rely on training and intentional suppression of those responses to be effective.

Control the setting when possible

In this case Wubbels was right where she needed to be and she did not have the luxury of selecting another spot. Staying in a more public place can be a good thing at times-especially when one party in the conflict has a much larger share of the power in the relationship (i.e. police or superiors). As professionals we also recognize that sometimes a public area can emphasize the performance aspect of the interaction. In this day of recording devices in everyone's hands, we are always conscious that we are being filmed. In an emotionally charged, even potentially violent situation, this can be helpful, but it can also lead to escalation of a volatile situation. While it is never advisable to be alone, it can be a good idea to take a few appropriate and selected individuals and to an alcove or a slightly separate area for conflict resolution.

Nurse Wubbels set the bar high for us as nurses to stand tall on behalf of our patient. By doing her job well, she inspires us to go for the gold in all our interactions on behalf of our patients.

Joy Eastridge, RN, BSN, CHPN