2 nurses arrested in CA.....

poe me · Jan 30, 2004

Even though I'm not a nurse yet, I will never hesitate to call a Dr. in the middle of the nite. I have seen some nurses where I work afraid to call the pts. Dr. They would rather let the pt. suffer til morning. NOT ME this is unacceptable. We are responsible for that pt. and if a Dr. wants to get mad so what. They need to understand that a pts. health is more important than their sleep. If they can't deal with the late nite calls then I would suggest they find a career other than a physician. This field is 24-7 we nurses realize that and so should Drs.

mattsmom81 · Jan 30, 2004

There was a thread sometime back regarding several ICU nurses who gave Diprivan in ICU because it was a protocol med for vents, but the hospital and docs were scapegoating them when they did what they thought they were 'supposed' to do.

This sounds like a different situation unless all the facts are not coming out. Doctors will play games and we must be careful. I've been told "always do this for my patients in the future" and later the doc denies saying it. Doctor, if you don't want a call at 3 am for pain/agitation/low potassiums, fever, etc....then come up with standing orders/protocols!!

BUT even WITH a protocol the docs will play games sometimes and say "I did NOT authorize the protocol...yes its on the chart with my standing orders for admission for vent patients,but I NEVER wrote the order to use it." ????? So do we use it or not dear doctor??? The games that are played in today's litigious society are overwhelming sometimes...

Poor leadership, apathetic management, and dysfunctional systems allow this stuff to go on. We as nurses must be very very careful and legally astute in these situations. Place your trust very very carefully, nurses.

BrandieRNq · Jan 30, 2004

Interesting situation....

Think of how many times you say to yourself/co-workers..."It's Dr. whoever, he won't care" or "I know the pt. a thousand times better than his/this MD on call Dr.!"

Often times we do know our pt.'s better. In fact we may be calling in the middle of the night to speak to someone who has never even laid eyes on the patient. Therefore, the night MD probably having little to no knowledge regarding the pt. It is the nurse who has the insight, the "clue", the idea of "what the pt. really needs". It's been my experience that the standard 2 am response by the MD when asked for something is "yeah, sure..." Requiring the nurse to then wake them up further during the phone call to specify route, dose, frequency.

I am not condoning the actions of these nurses, I would never have done what they did. However, it's interesting to consider where you draw the line...everyone has a different philosophy of what you might do when you "are sure that's what the pt. needs". Would you give Tylenol to someone with a headache who requests it even though you are unable to get an order due to lack of responce from the MD? Would you give the Tylenol at 1 am without an order for the same headache? What about Mylanta, Ibuprofen, any other drug that seems harmless but helps your pt. in the middle of the night?

FOOD FOR THOUGHT!

barefootlady, ADN, RN · Jan 30, 2004

Doctors playing games like this is why nurses MUST be careful and always have a witness to all verbal orders given. Also should ask other nurse to cosign when charting: Dr called/paged;

no answer or unable to reach or call not returned.

I ALWAYS ask a doc if he wants protocol orders instituted if he has protocol orders.

With computer charting being so big today, I include the name of the witness and inform them what I intend to say. All of this takes longer but in todays suit happy system, we must be mindful of our license.

barefootlady, ADN, RN · Jan 30, 2004

Sorry, did not answer question. I do not give meds without orders, even at 0200 am and it is Tylenol. Will call house doc if necessary. Worked with experienced RN who gave med w/o order, just Tylenol, messed up lab results and caused patient to have longer hospital stay. She was fired. The doc gets the big bucks for being called, no matter what the time. So I call. Some of the house doc get angry and ask "why call me?" I always say you are my last hope for med, Dr will not return call. If he gives order fine, if not, then I can chart, explain to patient, and let the Dr face the music in the am. I do not trust any doctor well enough to endanger my license.

fiestynurse · Jan 31, 2004

There is an alarming increase in the criminal prosecution of nurses, who make errors that result in the death of a patient. We helped bring the criminal system to this point by letting the public believe we're perfect and not accepting our role in human fallibility.

Many people believe that the criminal prosecution of nurses may have unexpected ramifications. Many fear that if nurses are criminally prosecuted for mistakes, they will be less likely to report mistakes, which puts patients in jeopardy. People might hide errors, especially those of lesser significance.

A clear line should be drawn when deciding which cases should lead to criminal charges. Only when a person intentionally harms a patient should there be a prosecution. All other instances belong in civil court. Any nurse who has harmed a patient is devastated. They're already punishing themselves.

BarbPick · Jan 31, 2004

Originally posted by sarahr5
2 nurses where arrested for giving a 80 year old man medication that was not prescribed by the doctor. The nurses worked on night shift and thought they would give him medication just to make him more comfortable because he was complaining of pain. So they thought instead of Disturbing the doctor they would just give him medication on their own.

Geez, why are nurses so scared of calling docs?

As a young nursling, I felt so bad for the intern cuz he had little sleep, so I gave a 13 year old 2 tylenol for a headache. I mentioned in the morning to the doc I didn't want to wake him, and told him what I did. I am so lucky I am still alive, and he didn't kill me. The child was on a fever watch for endocarditis and I prolonged her hospital stay by an extra day.

I call doctors in the middle of the night for a hangnail !!!!!!!!!!!

No Mercy !!!!!!!!!!

Wheaties · Jan 31, 2004

i dont know anything about doctor's orders and pain meds.

the way i was taught was that if the client was in pain, the nurse should give pain meds if the client wanted some, no questions ask.

does pain medication require a doctor's order? If the doctor didnt order any pain meds, and there are no pain meds on the client's medication record, does that mean the nurse can't give any pain reliever to ease the client's pain, unless it says so in the medication record?

stevierae · Jan 31, 2004

Originally posted by passing thru

...the patient WAS dying...............

Ummmmmm--would you perhaps feel differently if the patient was YOUR father, or someone close to you?

dragonfly954 · Jan 31, 2004

There was an article at work tonite about 2 nuses in a jail who didn't call the md about a juvenile having abdominal pain.they wre afraid to call at nite because of past explosions from the md.kid dies.both nurses arrested for murder. :eek:

tckoolaid · Jan 31, 2004

It appears that the two nurses did not have enough seasoning to call a grumpy Doctor. Understand that, but anytime a narcotic is used, my license gets itchy and a Doctor will be called. Been there with the tylenol before at night. Now we can see why nursing is so shorthanded, with sue-happy people out there. Terminal means its coming.

LydiaGreen · Jan 31, 2004

Originally posted by stevierae
Ummmmmm--would you perhaps feel differently if the patient was YOUR father, or someone close to you?

It was my father, and he was dying, when a nurse (tired of his constant agitation and confusion) gave him a "sedative" so he would stop trying to climb out of bed. The "sedative" had the opposite effect... my father went from agitated and confused to nightmare hallucinations. This was the ONE AND ONLY night my mother left his bedside to get some sleep at home. When she returned in the morning, my father was black and blue from head to toe from beating himself senseless against the siderails. Worse yet, he remembered the nightmare hallucinations, he remembered his fear and terror and this terrible experience remained with him to his last breath. If the nurse had called my father's doc, he would have ordered something else because my father had a history of opposing reactions to sedatives.

Don't know what happened to the nurse for sure. Know that my mother called the doctor at my urging that morning, the doctor pitched a royal fit, and we never saw that nurse again.