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....
Wow.
I've come to believe that patients who are in that position "hang on" for a reason. They are waiting for something.
Some patients wait until their family is out of the room and they are alone... some wait until a certain family member finally makes it there to be with them.... some wait until their family tells them that it is okay if they go... some may just pick a special day, like Christmas, Easter, their own birthday, the anniversary of their spouse's death... or what have you.
Maybe this woman was waiting for something. Who is your manager to say that this patient was "a waste of resources" and just had to go? Our job is to make the patient as comfortable as possible, not to KILL them! Last I checked, it was illegal to kill someone.
I can't believe some people suggest leaving and not reporting this. All RNs have a moral and ethical obligation to advocated for their patients. Leaving someone in that position who has verbalized such opinions, without reporting her to someone, would be just... unimaginable to me.
If you're leaving anyhow, what do you have to lose?
I have a hard time taking this manager's speech at face value. People don't enter into criminal conspiracies with people that they don't trust. So I don't think she was genuine in making this brazen suggestion to you, since you weren't the nurse who was "her best friend."
Two alternative explanations that I see:
Maybe she hates you, and wanted to set you up to be fired and/or prosecuted. After all, you'd have no way of proving that she said anything to you about it.
Or, maybe it was some bizarre test to see how you would respond.
Actually, with a little more time to think it over, I was able to come up with a couple more explanations:
1. The OP is trolling us, just for kicks.
2. The OP has to write a paper about an ethical dilemma and thought he/she would get more responses by pretending it was a true story.
I can't believe the story as written (and I don't mean, OMG I can't believe she said that! I mean, I literally can't believe it).
I'm not saying it's impossible that someone would get such an idea in her head. And I'm not saying that it's impossible she would decide to act on it. The impossible part is this: having got the idea and decided to act on it, she made the proposal to a non-homicidal nurse who happened to be working that shift. If the manager were really going to conspire to kill a patient, she would have made sure a nurse she was VERY close with was assigned to the patient.
Now, before anyone asks, I'm not an experienced murderer. My confidence in this comes from general observations of human nature. Why would this manager risk her career and her freedom just to save the hospital from "wasting" money?
Rhymeswithskeptical
I too had to come back to this thread tonight...after thinking about it, I am really having trouble believing it actually happened.
I did have a pt on comfort care once though....he had been hanging on for a few days. The doc came in and told me "you need to turn the morphine drip up alot higher." Of course he didn't write the order down. I knew what he meant and didn't do it. The pt was comfortable on the dose he was at...ended up dying the next day.
So I know stuff like this happens...but the senario in the OPs post seems off somehow.
Does anyone remember the thread a couple of months ago where the OP was deliberately antagonizing people to write a school research paper? It got pulled pretty quickly. This is this OP's first post and to have such a sensational one as this? I'm just sayin'........
I think that was the one about the new CNA on her first day of orientation observed the nurse put the call button up on a shelf so the patient couldn't bother the nurses every half hour. As the story goes, she snatches the call button off the shelf, gives it to the patient, and reads the nurse the riot act, asks her how she would feel if she couldn't reach her call bell, and invites the nurse out to the parking lot for a "chat". I think it ends when the nurse realizes the error of her ways, sobs out an apology, and she wins CNA of the Year. Or something. :uhoh21:
nursinger
129 Posts
My reaction also. Unfortunately, this may be happening more than we really care to know. God help these people.