I need help with management....*LONG*

Published

My nurse manager told me to kill my patient. The patient had ischemic bowel, CKD, on bipap, CRRT and pressors, had been for the past 3 weeks, and wasn't progressing in anyway and was a DNR/DNI. Wasn't getting worse, wasn't getting better.

She came into the room, told me about how medicaid was not going to pay for all of this, how expense all of this is, how much of a waste of resources it is, etc (the patient was a 1:1). She then asked if the patient had any pain meds. I stated that she had fentanyl and lidoderm patches on, as well as 2mg dilaudid ordered but we were only giving .5 mg because that would completely knock the patient out for hours, almost to the point of being in a coma (she was pretty unresponsive to being with, wasn't follow commands, nonverbal). She told me to give the 2mg, and not take a blood pressure for 2 hours. After 2 hours, when her pressure was "30/20 or whatever", we would call in the family. Now, the patient was on Levophed. I told her I couldnt do that. I don't kill patients and for legal reasons (she has a background in law), that if anything went to court, they would question me why I didn't take a blood pressure for 2 hours when they were on a pressor. The thing is, she was completely being serious. I was so scared that she was going to enter into the room and kill the patient, that I did not leave the room at all during that day. Well, the patient passed away that night. The nurse taking care of the patient, was the managers best friend.

I don't know what to do...I'm afriad I'll loose my job....

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I would leave this place of employment as soon as I could find a job elsewhere. I doubt that a police report would do you any good, because they would probably tell you it was only hearsay without any witnesses. Same with a report to the Board. The Board doesn't take action without a conviction. Just get away from her. You don't want to become implicated.

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I agree. That place is a disaster waiting to happen.

For what it's worth, it doesn't sound like you personally did anything wrong. In fact, you advocated for your patient and for that, I applaud you. :yeah:

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

God help us.

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Specializes in med/surg, psych, public health.
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I would run, not walk, away from any institution where I was asked to do something like that. Kill the patient? It's not like she's paying for the patient's care (like that is any kind of justification). You said she has a background in law, clearly she knows that this is illegal as well as immoral.

I might report it to the board anyway. Even if they couldn't take action it would make me feel better to put it on the record. Does your hospital have an anonymous ethics line? What about your chain of command (if you think you would be believed?)? This is very serious. You did nothing wrong. I personally would feel morally compelled to report it, but that is my opinion. There is tremendous risk in being a whistle-blower.

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Wow. ...Just, wow! I am without words!

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Crap, and OMG!

Where are you? In hospital? So glad you could realize what was really happening, musta been absolutely surreal! Glad you didn't bite. Hope you documented thoroughly what you did and nothing more.

Write a personal account of all you did, everything said, and put it in a file folder away somewhere at home. This so you can account if you are called to do so., and so that you can let it out of your mind so you don't have to keep hold of it and go nuts.

Now, find a new job.

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Specializes in ER.

Not surprising to me at all. Money talks, and this is just an extension of that.

We put our effort into patient satisfaction rather than patient survival or infection rates. Which measurement is quoted most often in staff meetings? Once insurance runs out don't you see patients discharged, and testing sharply drop? Nice to know exactly where you stand with this manager.

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Specializes in ER, L&D, RR, Rural nursing.

Wow, run,run,run away (if you are able to get another job), I wouldn't be so concerned about my job as I would be my license, my ethics, those pesky morals!!!

Although what would the patient want?(Just playin' devil's advocate!!)

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This just makes me sick. I can't believe your manager asked you to do this.

I think this needs to be reported to her boss.....I would have a hard time working with this person now that you know what she is capable (sp?) of.

Who does this woman think she is? It's not our job to decide that a human life is a waste of resources.....disgusting evil woman.

So sorry you were put in this situation. Please keep us updated on whatever you decide to do.

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Specializes in MDS/Office.

Why wasn't Hospice called in?

Personally though, I've wondered if Hospice has this same thinking......:icon_roll

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