Medication given against wishes

[nurse7272]

Recently a close relative of mine was admitted to the hospital for surgery. Post-operatively she had quite a bit of pain and had one day in particular in which the pain was uncontrolled for her. Her nurse came in and suggested a shot of IV Ativan that was on her order set as standard protocol by her physician for anxiety or insomnia. The nurse strongly encouraged her to try the Ativan and stated that she would be getting no more pain medication per the doctor's new orders. My relative refused the Ativan because she felt like it was an absolute pain control issue and not one of anxiety. After a short time the nurse came back in and gave my relative something in her IV stating, "This will make you feel much better". She asked what it was and to her horror the nurse said, " I went ahead and gave you the Ativan because I think you needed it. You are very anxious".

To make matters worse, (this was a 12 day hospital stay) we found out after a nurse friend assumed care the next day that the IV pain meds had not been discontinued and the nurses has only told her that to keep her from asking for it. This was an abdominal surgery that was laproscopic but extensive and the surgeon had to deal with a lot of complications during the surgery that included a lot of manipulation becaude of severe scarring from previous surgeries. He explained that pain would absolutely be an issue and he covered this by ordering Dilaudid 1 mg every 2 hours as needed for pain. I believe that the nurses became tired of giving this medication and when he felt a PCA pump would not be appropriate for my relative (she became oversedated before) this was the way they handled it. They lied to her and led her to believe that she had no medication for pain and gave her the Ativan as a way to try to sedate her.

The timing of this entire event coincided with the surgeon being out of town for several days so he was not there to witness this. When it was addressed upon his return he sent in the nurse manager and a patient representative. He also consulted a pain management doctor to help get her pain under control. We are frustrated because we feel the hospital has not taken appropriate action to resolve this matter. No one has contacted my relative to discuss this and she has such a fear now that she has cancelled 2 surgeries and several minor procedures that she needs to have. She has admitted that she has had nightmares about this incident and feels like she can no longer trust anyone that she encounters in a hospital setting. I am unsure what to do to help her. I would never dream of giving someone a medication that they clearly refuse. I have encouraged her to contact an attorney at the very least. I am wondering if anyone has any advice as to how I can help her handle this. I have been a nurse for 8 years but I am at a loss as to what to do. I think the hospital is avoiding her and I think they need to address this issue and do something about it. I have thought about reporting the nurse to the nursing board but I don't necessarily want to cost someone their job. I think at the very least the staff should be reprimanded and re-educated about pain and patient rights. I know this has not been done because I have a close friend who works on that same floor.

[baker1bv]

If thr hospital refuses to take appropriate action then take it to the state's board of nursing, not only what yhe nurse did wrong its illegal.

[diva rn, BSN, RN]

You can not rely on hearsay. Your relative would need to retain an attorney to requisition her medical records. If in fact, she was given Ativan, or any medication, against her will, I believe that would be considered battery. She would have a strong case against that nurse and the hospital. But she needs legal advice and the actual medication administration records.

[netglow, ASN, RN]

Since you were not a witness, you can do nothing but simply give her the advice that you have already given. You really can't be anything but supportive to her.

It's hard to have family thinking you can/should do anything just because you are a nurse, when, in fact you have nothing to offer but support as any other family or friend would.

[Nascar nurse, ASN, RN]

1. See if the hospital has some kind of an official "compliant" department. I was misdiagnosised last year and I was assigned a particular person to advocate for my concerns. I had plenty of proof (they missed a DVT on an ultrasound but second ultrasound the next day at a different location showed a clear DVT running from ankle to mid thigh and a d dimer of 4000). My assigned advocate actually did a very good job for me and got my entire bill erased.

2. Your friend, the nurse on the unit, should not be disclosing to you any information about this other friend. That is a pretty clear HIPAA violation and your nurse friend could get in real trouble and lose her job for that too.

3. I understand your anger over the way your friend was treated and I would probably feel the same in your situation but I ask you to really give it thought before you start calling the BON on a fellow nurse. Are you absolutely sure you know ALL the circumstances? If you call the BON - it may not be about losing her job - it maybe losing her license. If she messed up she does need counseled but in my opinion it is way to harsh to get the BON involved.

[Munch]

It's actually against the constitution to give medication to a patient if a patient doesn't want it. Hopefully the Ativan that was given was documented if not then it's the patients word against the nurses if indeed you do get an attorney involved. And as it was stated your relative has to report it not you, because if she doesn't then it is indeed hearsay. I took a lot of law classes at John Jay College of Criminal Justice before changing my major and schools so if you have any questions about attorneys or the law you can message me if you are so inclined. I'll be happy to answer any questions you have. My uncle also happens to be a malpractice attorney so if I don't know the answer to your question(s) my uncle surely will.

[Double-Helix, BSN, RN]

OP, the only thing you can do is continue to encourage your relative to consult a lawyer. Offer to get the contact number for her. Find out if there is a specific department that she can file a formal complaint with about this issue. If you family member was given a medication without her consent, and her ordered pain medication were withheld, leading to harm, then she should definately needs a legal representative.

But as her family member, your role is limited. A lawyer is what she really needs to help her get the compensation she probably deserves.

I understand your anger over the way your friend was treated and I would probably feel the same in your situation but I ask you to really give it thought before you start calling the BON on a fellow nurse. Are you absolutely sure you know ALL the circumstances? If you call the BON - it may not be about losing her job - it maybe losing her license. If she messed up she does need counseled but in my opinion it is way to harsh to get the BON involved.

Actually, I disagree. If the claims made by the patient are true, this nurse is guilty of assault and battery- chemically restraining a patient against their will, lying about doctor's orders and with holding pain medication. These actions led to both physical and emotional harm for the patient involved. This isn't a matter of "messing up." This is purposeful illegal and unethical action. If the OP contacts the BON, there will be an investigation and if the claims are substantiated, there will be disciplinary action. The nurse isn't going to lose her license if there is no evidence against her.

Your friend, the nurse on the unit, should not be disclosing to you any information about this other friend. That is a pretty clear HIPAA violation and your nurse friend could get in real trouble and lose her job for that too.

Nascar nurse, I think you need to re-read what HIPAA is actually about. HIPAA protects confidential health information from being shared with those who have no business knowing it. Hospital gossip, (such as whether the nurse in question has been disciplined) has nothing to do with HIPAA.

[sharpeimom]

sprinkles85, i think you avatar is absolutely adorable! i just love that face!

[Nascar nurse, ASN, RN]

To make matters worse, (this was a 12 day hospital stay) we found out after a nurse friend assumed care the next day that the IV pain meds had not been discontinued and the nurses has only told her that to keep her from asking for it.

Your friend, the nurse on the unit, should not be disclosing to you any information about this other friend. That is a pretty clear HIPAA violation and your nurse friend could get in real trouble and lose her job for that too.

Nascar nurse, I think you need to re-read what HIPAA is actually about. HIPAA protects confidential health information from being shared with those who have no business knowing it. Hospital gossip, (such as whether the nurse in question has been disciplined) has nothing to do with HIPAA.

This is the comment I was referring to - In re-reading it I may have initially misunderstood. I initially took it that the nurse friend was only telling the OP about the pain meds. Now I'm reading the "we" in the sentence so maybe the patient was actually present too.

I am well aware that HIPAA has nothing to do with hospital gossip.

[nurse7272]

We do have the records and it does show that it was adminitstered.

[nurse7272]

No hippa violations have occured. The friend is the same one who assumed care the next day and only knows what she had access to in the chart during her assigned shift. The only thing she has disclosed is that no education about this incident had happened on the unit. This is normally what would take place after such an incident and complaint.

[nurse7272]

Thank you. I do believe this is a legal issue and any help you can pass on to me would be greatly appreciated.