14 Nurses Fired and 9 disciplined in Kentucky

barefootlady, ADN, RN · Oct 11, 2003

Why in the world did these nurses do this? This is just too scarey.

gwenith, BSN, RN · Oct 11, 2003

Sounds like there is more to this story. No offense nurse attorney but there has to be a reason.

Ann42 · Oct 11, 2003

I thought they explained the reason quite well here: http://www.courier-journal.com/localnews/2003/10/04ky/wir-front-nurse1003-5433.html

iliel · Oct 11, 2003

why would you risk your career and livelyhood, and risk a lawsuit, and even safty of a pt all so the dr can sleep.

Personally, I'll call the dr, he can yell at me all he wants as long as he's yelling the orders for the meds.

jadednurse · Oct 11, 2003

"She said when they're (patients) pulling their tubes out and acting combative, you have to act fast, and that's what they (nurses) were told to do," Ziegler said. "She said everybody did it," including some who haven't been disciplined.

Ziegler said one of the nurses acknowledged it was a mistake to not have called a doctor, but said she was reluctant to wake up a doctor in the middle of the night.

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Good grief! This one deserved to be fired due to sheer stupidity!

Tweety, BSN, RN · Oct 11, 2003

Gee, so many nurses doing it. Seems like it was just institutionalized that they all just took it as a standing order, but how did they document? I guess they didn't. So technically they practiced medicine. They really don't have a defense. But I do think it's a shame they got fired.

Just goes to show you. Get your own malpractice insurance because the hospital is only going to cover their own butt, not yours.

Plus, "One of them confirmed that nurses administer the sedative for the benefit of the patient so doctors can sleep. " Is rediculous. As a long-time night shift nurse, I laugh at that.

grouchy · Oct 11, 2003

This had to have been institutionally sanctioned. Obviously, the Diprivan, which I understand is pretty expensive, had to have been getting charged to the patients, just to mention one issue. This investigation needs to go beyond just firing nurses. I want to see administrators and doctors with their butts on the line.

FROGGYLEGS, LPN · Oct 11, 2003

It does sound like somewhere down the line they were either told or encouraged to just give the Diprivan if a case like this rather than wake the doctor at night. I've seen nurses encouraged to give prescription medications without an order for the sake of convenience numerous times (myself included). Many times you *know* that if you give the med the problem will be stopped, but it will be your butt on the line if something comes up about it later. I can pretty much guarantee you that nobody will recall advocating the practice.

Personally, I don't think these nurses have a leg to stand on. It is a bad and unfortunate situation. There really isn't any way around the fact that all nurses (I hope) know that you can't give medication without an order.

The precious doctor that is going to lose sleep over a nurse calling him at night is being paid to be on-call. I'm sure he is being paid quite well. Who cares if you have to wake him up; if he didn't want to be on-call he shouldn't have accepted the position.

Teshiee · Oct 11, 2003

It would have been simple to make it a standing order! Or why is it tha MD's feel like they can't be called for an order of a certain med during the night? That is where the issue really is a nurse should not feel intimidated, pressure to call a MD during the middle of the night because he/she will become belligerent! Especially to the point where your license can be revoked! It is not worth it. I wish one of those nurses thought of just getting an order for diprivan then this wouldn't be an issue!!! Nurses usually don't have a leg to stand on the rules state not to give meds w/o a md's order clear cut. I think in the future some managament needs to post that calling your MD is not a federal offense!

stevierae · Oct 11, 2003

I agree with Teshiee. In most ICUs, there is a standing order for SOMETHING to give ventilator patients who are "fighting the tube." As a matter of fact, as an OR nurse, I know the anesthesiologist usually WRITES an order for that very reason, or the ICU intensivist can write it, or whoever is writing ventilator orders can write it. There has got to be more to this story. ICU nurses are pretty savvy--I can't imagine they would put their licenses on the line just to let a doctor sleep. Was there a standing order for a different med--like Fentanyl--and they chose to use Diprivan instead? Did they plan to ASK for a standing order for Diprivan, and one was never actually put in place, except perhaps verbally? I don't get it. Something is missing in this story.

FROGGYLEGS, LPN · Oct 11, 2003

I agree. There has to be something being left out about this. That is a lot of nurses breaking a basic rule.