HELP!! Hospital covering up a murder???

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I have a problem that I neded your opinions on-First, let me say that what I'm about to describe DID NOT happen to me, or in the hospital where I work. I was talking to another nurse who works FT in a nearby hospital, and occasionally with us. At her FT job, she is a Charge Nurse of a med/surg floor days.Last week her floor got a patient who was a DNR.This patient was an elderly lady who's family agreed to comfort care. She was placed on a morphine drip and trans. out of the ICU, to the floor to let nature happen. The pharmacy sent the 50ml bag of NS with 50 ml morphine for a 1ml/hr drip around 1230. The patient got to the MS floor around 1430ish. The patient's family was there. The granddaughter was there, along with her MD boyfriend. I do not know who this MD is (the nurse wouldn't tell me his name), but apparently he is known to that hospitals' staff- I got the impression he might have been employed there at some time, but isn't now???(Loss of privelages??) So- Grandma gets settled in, and the boyfriend/MD approaches her nurse and states "Can we get her a morphine bolus to speed things along?" She directs him to the CN, who immediatly tells him NO, and calls the supervisor to let her know what was said. :uhoh3: The boyfriend/MD insists on speaking with the attending MD, who just happens to be inhouse at the time. Again, the boyfriend/MD asks if he can order a bolus to "Hurry things along." The attending calls the CN, asks how the patient is looking- Cn tells him resps are 8/minute and pt. doesn't appear to be in any pain. Attending Doc says OK, keep everything the same, NO BOLUS ordered.The family and Boyfriend are made aware. Approx. 1/2 hr later, the call light goes on- BF says "She needs another IV bag, cause this one is EMPTY"- There should have been at LEAST 40 ml of NS/morphine left in the bag.Supervisor and Attending MD are called, up the hospital chain of command it goes, hospital lawyer gets called in, EVERYONE has to submit an incident report. The CN puts right in hers that she felt the bf/MD did it.Now here is where It gets even worse. The administrators/lawyer orders the pump taken out of the room.It isn't saved for the police. Either is the IV bag. The hospital tells everyone involved that they will handle it internally, and NOT to speak about it.The lady had severe liver damage to begin with, and didn't die for several hours.Am I wrong, or is the hospital trying to cover up a possible attempted murder? Aren't they bound by law to alert the police?? Isn't that "Elder abuse" if nothing else, and a state reportable incident? The pharmacy was contacted and made aware that 40 mgs of morphine is gone.Don't they have to account for controlled drugs? :confused: And what about this MD?? I really don't like the idea of someone like that being around patients.Obviously the hospital will try to cover it's own buttocks, but what about the poor nurse who had the patient. Couldn't she get in trouble because 40 mg of morphine is missing? What about the other RNs involved. Couldn't they have problems with their liscenses, ect. if it comes to light that they knew about a possible felony, but never called the police/nursing board ect.? Don't they have a legal responsibility to alert someone about this possible murdering Doc.? I was floored that she didn't seem concerned about those things. She felt that because she reported it to the hospital, she is covered. But if a patient is suspected of being abused and they are child/elderly the nurse HAS TO REPORT IT, even if it turns out not to be true, they are still mandated to report it. How is this ANY different?? What would you have done? I urged her to contact a lawyer-better to be safe than sorry.

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This whole scenario is questionable to me. Narcotic infusions are given through a locked pump to which this 'MD' or anyone unauthorized would not have access.

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Specializes in Cath Lab, OR, CPHN/SN, ER.

Ditto- our narcotics are given thru a locked pump, need a key to get into. Is that how your's is set up? If so, it could have been a pump malfunction. Sounds like a difficult situation. -Andrea

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This whole scenario is questionable to me. Narcotic infusions are given through a locked pump to which this 'MD' or anyone unauthorized would not have access.

Yes, if you have a PCA or epidural. But in our hospital (as well as the one we are talking about) Morphine gtts. are put on a regular IV pump. There is a "lockout" button on the back, but it's only a toggle switch, used for grabby confused patients.And it says "Lock Out" above it. I'm thinkin if he's smart enough to get through med school, he could figure out a toggle switch marked like that. WE don't usually use that lock out option at our hospital.

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I would suggest having your friend call the state board of nursing to protect his or her own license. With that much morphine missing the nurses lisence could be on the line. The state board could make some suggestions about what to do from there.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

why on EARTH would morphine be in an unlocked regular pump, that can be changed by a toggle switch? THAT is LOUSY practice, period.

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Specializes in LTC.

Did anyone check this guys arm for needle marks? Maybe he infused the morphine himself???

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Specializes in Med/Surg, Geriatrics.
why on EARTH would morphine be in an unlocked regular pump, that can be changed by a toggle switch? THAT is LOUSY practice, period.

Right! Maybe the hospital wants to cover their butt because they know they are in violation of federal law in regards to securing schedule II narcotics.

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I've only seen morphine drips done with a regular IV pump, never a PCA-type pump.

I would definitely start making some noise about this. It's wrong on the hospital's part to cover it up. And it definitely makes me wonder about the doctor/family member.

It's probably too late now since the evidence has been trashed, but it can at least be made uncomfortable for the hospital admin and the idiotic person who did it.

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Specializes in Critical Care/ICU.
I've only seen morphine drips done with a regular IV pump, never a PCA-type pump.

Ditto. 99% of the time we hang morphine, fentanyl, dilaudid (for epidural) bags on our regular baxter pump (we often bolus straight from the bag as well). This is in the ICU. I know it to be true though that on the floors, they use a locked device.

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Did anyone check this guys arm for needle marks? Maybe he infused the morphine himself???

Yes, this is the trouble with Morphine drips infusing outside a PCA...it is easily tampered with...particularly by a healthcare worker with access to a syringe.I have had family members attempt to tamper with narcotic infusions before...:(

So this might be a theft situation vs a mercy killing or whatever. sounds like baby doc was either playing God or had a habit.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

well those of you hanging narcs on unsecured pumps best be thinking TWICE about this practice. It's really, really dangerous and puts you in extreme liability. Who will get screwed should said narcs go unaccounted for or someone dies???? And who is keeping track of how much is used and how???? This is very poor practice, and I doubt JCAHO would like this one....

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