Ohio Hospital Fires 23 After Fentanyl Overdose Deaths

It sounds like these are all reasonable actions. Bypassing safety measures that were in place. Not questioning MD orders by both the RN and Pharmacist (seriously, 2,000 mcg of Fentanyl and 10 mg of Dilaudid?? Hospice pmts dont even get that much at one time).

However, what really angers me is they punish the RNs and pharmacists, lower level managers (rightfully so) yet several higher ups got to "step down" and "retire". Unreal. 

Edited Jul 17 by OUxPhys

19 minutes ago, OUxPhys said:

It sounds like these are all reasonable actions. Bypassing safety measures that were in place. Not questioning MD orders by both the RN and Pharmacist (seriously, 2,000 mcg of Fentanyl and 10 mg of Dilaudid?? Hospice pmts dont even get that much at one time).

However, what really angers me is they punish the RNs and pharmacists, lower level managers (rightfully so) yet several higher ups got to "step down" and "retire". Unreal. 

I 100% agree. To repeatedly circumvent warnings and to go against recommendations and standards is wrong. 

52 minutes ago, OUxPhys said:

It sounds like these are all reasonable actions. Bypassing safety measures that were in place. Not questioning MD orders by both the RN and Pharmacist (seriously, 2,000 mcg of Fentanyl and 10 mg of Dilaudid?? Hospice pmts dont even get that much at one time).

However, what really angers me is they punish the RNs and pharmacists, lower level managers (rightfully so) yet several higher ups got to "step down" and "retire". Unreal. 

This sounds like someone blew the whistle on a palliative sedation program. I highly doubt these were mistakes made by bypassing existing safety measures, these were likely deliberate interventions. 

How would you punish non-clinician senior leadership who likely never stepped foot on those units let alone know what was happening? 

6 hours ago, J.Adderton said:

Husel was not removed from patient care until November 21, 2019. 

I assume this is a typo where I am its still July 2019. unspeakable what this doctor did to those patients.

This sounds like a badly-run hospital where physicians were allowed to run their own programs with minimal oversight and accountability.  The pharmacists and nurses who spoke out about this and refused to participate are long gone; we'll likely never hear from any of them.

The ones who stayed and played took a bigger chance than the ones who left; it doesn't seem to have paid off.  This is the danger of group-think and thinking there is safety in numbers.

This is ridiculous! "Now that they don't want any life saving measures, let's just off them so we don't have to waste a bed on them", is the thinking that comes to mind. And I am sure that this was supported by the hospital administrators. Sick.

What I also find sick is how quick they were to fire and blame the RNs and RPNs/LPNs that administered the medication. I hope that these nurses sue the hospital, too. I am sure the ones that protested the high dose of medication were either let go, reallocated or disciplined for "insubordination", yet the ones that chose to give in to the pressure and administer as ordered and save their job to support themselves and their families are the ones to be reported to the BON and have their whole lives destroyed because of this angel of death? Its ridiculous. Not to perpetuate ideas of victimization, but nurses always seem to get the short end of the stick. Dammed if you do, dammed if you don't. These nurses that were let go should sue this hospital too for their blatant negligence and recklessness. The firing of staff was simply a PR tactic to make it look like they were taking this seriously and these fired staff were scapegoats in the tactic to save the reputation of the hospital. Its sick. 

Edited Jul 17 by steven007

1 hour ago, steven007 said:

 

I am sure the ones that protested the high dose of medication were either let go, reallocated or disciplined for "insubordination", yet the ones that chose to give in to the pressure and administer as ordered and save their job to support themselves and their families are the ones to be reported to the BON and have their whole lives destroyed because of this angel of death?

Yes.  It's called ethics.  I've always been prepared to dumpster-dive (or preferably wait tables or stock shelves) before I participate in something I know to be wrong.  What you call giving in to pressure I call group-think.  It's never the safer option that some people think it is.

They are all professionals and can be held legally accountable for their own practice.  "Giving in to pressure" does not provide much of a defense in court or one's respective licensing board.

10 minutes ago, TriciaJ said:

Yes.  It's called ethics.  I've always been prepared to dumpster-dive (or preferably wait tables or stock shelves) before I participate in something I know to be wrong.  What you call giving in to pressure I call group-think.  It's never the safer option that some people think it is.

They are all professionals and can be held legally accountable for their own practice.  "Giving in to pressure" does not provide much of a defense in court or one's respective licensing board.

I agree and this is a very valid point!

However, where I disagree is that it is actually a valid defense in court. Its called undue duress and has been argued quite successfully in cases here in Canada. If your employer places you under undue duress, you can absolutely get off the hook. 

I'm a law student and I volunteer for a nursing union to gain first-hand legal experience. I have used this argument before with great success, albeit with an arbitrator (not a judge). 

All the nurse has to prove is:

1. Others who spoke up were disciplined, reallocated or fired to the point where the culture was "just go with it" 

2. They had extenuating circumstances that did not give them an option to leave (i.e. supporting a family, children, etc.). 

3. They attempted to mediate the situation (i.e. by finding other employment).

If those 3 factors are met, you have undue duress and a valid defense. Obviously, I don't know the whole story and I am sure some of the nurses involved likely wouldn't meet this defense and willingly participated in this nonsense. But I am sure, there is probably one poor soul, one inexperienced graduate nurse, that really felt that there was no other option. And for that person, my heart goes out to him/her. 

Edited Jul 18 by steven007

15 minutes ago, steven007 said:

I agree and this is a very valid point!

However, where I disagree is that it is actually a valid defense in court. Its called undue duress and has been argued quite successfully in cases here in Canada. If your employer places you under undue duress, you can absolutely get off the hook. 

I'm a law student and I volunteer for a nursing union to gain first-hand legal experience. I have used this argument before with great success, albeit with an arbitrator (not a judge). 

All the nurse has to prove is:

1. Others who spoke up were disciplined, reallocated or fired to the point where the culture was "just go with it" 

2. They had extenuating circumstances that did not give them an option to leave (i.e. supporting a family, children, etc.). 

3. They attempted to mediate the situation (i.e. by finding other employment).

If those 3 factors are met, you have undue duress and a valid defense. Obviously, I don't know the whole story and I am sure some of the nurses involved likely wouldn't meet this defense and willingly participated in this nonsense. But I am sure, there is probably one poor soul, one inexperienced graduate nurse, that really felt that there was no other option. And for that person, my heart goes out to him/her. 

Thanks for this.  I didn't know this could be pulled off in Canada.  To the best of my knowledge, it doesn't work well in the States.  (But maybe it has and we just didn't hear about it.)  I think the takeaway is that "going along to get along" has huge backfire potential.

If you, as a staff nurse, were assigned to have Husel's patient and had orders to administer the lethal amount of meds, no matter what choice you made, you would be ended up in trouble. If you administered the meds, you were fired and reported to the board. If you refused to administer the meds, you were disciplined or fired. It's so sad the staff nurse's career is a matter of luck. If you were not lucky enough and got assigned to Husel's patient, you were done. Maybe only staff nurses who can afford to resign can survive in the situation.

I'm with TriciaJ.  Much simplier situations have come up and I flat out would not do them.  My response, "fire me" or "write me up".   I have not lost a job yet.   But I am willing to do whatever job to support my family if need be.