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Ohio Hospital Fires 23 After Fentanyl Overdose Deaths

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J.Adderton has 26 years experience as a BSN, MSN .

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48 Nurses and Pharmacists Reported to State Licensing Boards

A hospital in Ohio recently fired 23 physicians, nurses and pharmacists after 25 patients died from excessive doses of fentanyl. In addition, 48 nurses and pharmacists were reported to state licensing boards for their roles in the overdoses. You are reading page 6 of Ohio Hospital Fires 23 After Fentanyl Overdose Deaths. If you want to start from the beginning Go to First Page.

imintrouble has 16 years experience as a BSN, RN and specializes in LTC Rehab Med/Surg.

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Weeks ago, when this story hit the news, my first thought was what about the nurses.  I wondered what kind of pressure they were under to give a drug and dose they knew would kill.   How could they do it?  I never considered they didn't know what they were doing, I wondered why they did it.  I still wonder why.  It's got to be more than just fear of losing a job.  It has to be.  

I'm sure there's all kinds of psycho mumbo jumbo that explains it.  There are even social experiments that show people can be made to do the unthinkable. But a nurse and patient is a whole different thing. 

I hope someday the nurses involved will share their story.

 

 

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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11 minutes ago, sassyrn333 said:

Oh, you don’t draw the conclusion of Nazi Germany = Hospital Industrial complex 😬  K. Enjoy living in your denial.

Oh Im well aware of the hospitals and their shadiness but never have I thought Nazi Germany.

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Luchador has 5 years experience as a CNA, EMT-B.

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2 hours ago, sassyrn333 said:

I see a lot of “Florence Nightingale” wannabes on here...trying to be self righteous. Judgemental AF. I think there are many details left out of this story (like duration of time the doses were delivered over)...but some people just aren’t smart enough to ask more questions. 

But ya’ll sure do love to VILLIFY.  

Maybe you should try supporting your peers rather than your administrators... I find my moral compass aligns with true north. How bout you????

Hospital Industrial Complex = Nazi Germany. 

Get your mind right people. 

 

Under what circumstance would You give a patient a paralytic and remove them from vent?

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organichombre has 32 years experience and specializes in critical care, med/surg.

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What's sad is that a culture was created where many thought it was all well and good...we provided those palliative patients with a way out. Nurses, be aware of the embedded culture wherever you may work, it does not happen by accident.

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Trust your gut always.  MD’s/DO’S/NP’s/PA’s get tired in this “Narcotic Crisis,” and write checks your BON WILL NOT CASH😳!!!!!

If you have “The First Reservation,” do not administer the order.

Your License can be insured, it CANNOT be Guaranteed.

(During my tenure as an RN, NP- many drug companies were coming to Hospitals talking about the “Patient’s Right to be Pain Free.”

I have seen that cost many HCP’s their Professional Licenses.

Chart like your children’s lives(you may not have children), but pretend you do have hungry children, and they ARE hungry, and your decisions with Narcotics depend on YOUR ability to feed them.  

This NEW government mentality doesn’t need you to “mess up,” or “make a mistake,” only to “give more pain relieving medications than fellow nurses on other shifts.”

Then, “Game Over.”

Edited by VykingboyRN

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KalipsoRed21 is a BSN and specializes in Currently: Home Health.

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On 7/17/2019 at 8:16 PM, 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.

Your terms for “ethical” are snotty at the very least and self righteous at the very worst. ‘Group think’ may not always be the safer option, but beating the drum at your own paces is just as dangerous as becoming sheeple.  Your whole “going to wait tables, dumpster dive, etc.” is nobel but most people are not working just support their own lives, usually their income effects children or their work hours affect the amount of care they provide to their elderly mother. 

Your idea that justice only occurs when those  who give in to pressure to go along with the crowd get faced in a courtroom for the one action they have been found guilty of and not the many circumstances that lead to that choice, is a child’s view of the world. 

As a freshman nurse I was told to discharge a patient who was new to dialysis, had not been set up with a dialysis center, and the MD had not reconciled the medications. I asked about these issues and got yelled at by the doctor. Then I got a phone call from my director of nursing yelling at me that I was going to be reported to the board for insubordination of doctor’s orders. Then said patient ended up coding and his life was saved because I hadn’t discharged him. Then I got an award for being a “safety star”. The doctor never apologized nor did he get reprimanded, my director never apologized. No goals were made to improve anything, because, you see, I was threatened with my license and my livelihood for following hospital policy. 

That all traumatized me and I well understood that I, regardless of my fancy BSN, was a scapegoat for whoever held the money and the power. And no amount of fancy ‘nurses have power speech’ since has been able reverse that lesson. Mostly because those speeches are just pretty words and happy thoughts with no REAL changes to protect a nurse for saying no.

There has not been a job that I have had in the last decade where I felt I got a complete and safe education on a new procedure or practice before I was made to preform it and I can’t tell you how many times I’ve looked something up on YouTube because I got no training at all. 

But in the last decade I have gone from working as little as possible in this nasty career to at least trying to maintain full time hours so that my dad wasn’t homeless and that I can help my mom with groceries. When someone’s paycheck provides the stability for more than just themselves, and they are caught in a manipulative career that always ends up with the finger pointed at them no matter what they do, how can you expect them to be ‘ethical’. Furthermore, why do some of the lowest paid people in this hospital’s hierarchy get criminally charged and have their LIVELIHOOD threatened/taken away but the CEO and other upper level management just get to retire? Are you so naive to believe that the tippy toppers running this show had no clue that they had a doctor like this on their staff?!?!? Bull. They knew, and when some nurse brought it up s/he was written up about not putting periods at the end of their sentences, being 2 minutes late in a snow storm, and having a bad attitude until they were fired. 

The nurses and pharmacists should get no reprimands. It is a nurse and pharmacist’s job to follow the orders of the physician. And until that authority is not entirely in the hand of the physicians/NPs/PAs, until a nurse can preform under protest without loosing their livelihood, this crap will happen over and over again. 

Accountability seems to only be a term that has meaning for those lowest on the totem pole and that has to stopped. When this stuff happens, if we are going to criminalize the nurses and pharmacist around these issues then those at the very top should be charged as well just for not paying better attention.

 

 

 

Edited by KalipsoRed21

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Luchador has 5 years experience as a CNA, EMT-B.

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30 minutes ago, KalipsoRed21 said:

It is a nurse and pharmacist’s job to follow the orders of the physician.

 

 

Not so much. Nurses are to protect patients

Edited by Luchador

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KalipsoRed21 is a BSN and specializes in Currently: Home Health.

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4 hours ago, imintrouble said:

Weeks ago, when this story hit the news, my first thought was what about the nurses.  I wondered what kind of pressure they were under to give a drug and dose they knew would kill.   How could they do it?  I never considered they didn't know what they were doing, I wondered why they did it.  I still wonder why.  It's got to be more than just fear of losing a job.  It has to be.  

I'm sure there's all kinds of psycho mumbo jumbo that explains it.  There are even social experiments that show people can be made to do the unthinkable. But a nurse and patient is a whole different thing. 

I hope someday the nurses involved will share their story.

 

 

I hope they can too. The fact that it was 48 nurses and pharmacist makes me believe that A) someone must have said something before and got hushed. B) I would like to know how much experience these nurses and pharmacists had when they pushed these drugs, cause let’s face some facts people, 1-2 year olds would possibly not know how high these doses are. We all live in this stupid world where there are people who think that nursing school and passing the NCLEX makes one a safe nurse. Experience, good mentors, and teamwork make one a safe nurse. I made it out of my nursing program testing off on my IV skills with a computer program using a mouse....never did it on a real person until I was a new grad, I think nursing school is just another paper one needs to meet the qualifications, but I didn’t learn a 10th of what I needed to know.

I can honestly say that in reading the article that only fentanyl and dilaudid are the doses I am most familiar with and can tell how crazy high these doses were. I wouldn’t have caught it off hand with the other listed drugs. 

Lastly these were all terminal patients moved to comfort care. In the hospital comfort care is left to bedside nurses that have no training in hospice. I have no training in hospice, I would assume comfort care has higher than normal or more frequent than normal doses of medications, but as I have said before, we are all to often put in situations where we have no training and those around us have no training, that none of us know. So we rely on the order. And what is worse is that you get a nurse who doesn’t know, who’s had a couple of this MD’s terminal patients and starts to think that these sort of orders are standard. 

To those nurses and pharmacists, this is not your fault and I hope you fight tooth and nail to pin this on the real culprits: the doctor and the administrators.

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Luchador has 5 years experience as a CNA, EMT-B.

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4 minutes ago, KalipsoRed21 said:

 

To those nurses and pharmacists, this is not your fault and I hope you fight tooth and nail to pin this on the real culprits: the doctor and the administrators.

Any first year RN student knows what a paralytic does and why you would never take a pt off a vent after giving a paralytic.

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KalipsoRed21 is a BSN and specializes in Currently: Home Health.

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1 minute ago, Luchador said:

Any first year RN student knows what a paralytic does and why you would never take a pt off a vent after giving a paralytic.

Nope, I disagree.

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Luchador has 5 years experience as a CNA, EMT-B.

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Just now, KalipsoRed21 said:

Nope, I disagree.

Well I just finished my first year, so you're wrong

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TriciaJ has 38 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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30 minutes ago, KalipsoRed21 said:

 

Accountability seems to only be a term that has meaning for those lowest on the totem pole and that has to stopped. When this stuff happens, if we are going to criminalize the nurses and pharmacist around these issues then those at the very top should be charged as well just for not paying better attention.

 

In the interest of space I didn't quote the whole rambling diatribe.  Nowhere have I advocated that those at the top get a free pass.  The fact is that licensed professionals can and do get held accountable for their own practice.  "Just following orders" will not save your livelihood.

Hospitals can threaten your license all they want but it's the BON that determines this.  Nurses are placed in Catch-22 situations all the time.  Personally, I've always been more willing to risk my job than my license.  I could always wait tables until I find another nursing job.  If I lose my license, I'm looking at waiting tables forever.

Of course it isn't always easy to stand up for what's right.  Of course there are still repercussions.  But what is the alternative?  Sometimes you have to pick your poison.

We've all been in situations where we were intimidated, threatened, desperately needed the income, were working short-staffed, etc. etc.  We can cut one another all the slack you want.  Unfortunately the BON, legal system and general public are not always very understanding.  As individual nurses, we need to be painfully aware of that every minute, and be prepared to govern ourselves accordingly.

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