Outside nursing scope of practice-don’t do it

A confused, 94 year old patient trying to get out of bed. We’ve all been there. Sometimes it is impossible to re-direct their energy and their determination to get out of bed. It happens. It certainly did in a Lexington, Kentucky hospital. I can understand the nurse’s frustration.

She reached out to the patient’s doctor, asking for something to help calm the patient down. The doctor said no. Did he explain the reasoning to this nurse? We have no way of knowing. I would hope so.

The nurse, unable to get an order for medication, took it upon herself to pull out the medication she wanted from a different patient’s supply. She then prepared a syringe and gave the patient the medication. That was intended for another patient. Without an order.

I’ll pause here why you pick up your jaw from the ground.

I was certainly taken aback when I heard of it.

This is operating outside her nursing scope of practice. And is a big NO-NO. And illegal as hell.

Oh, it gets worse.

Other nurses asked her what she was giving the patient via injection. They probably knew that the request for an order had been denied. Because nurses in that situation love to talk smack about what is going on. I can imagine that conversation ‘I asked for come calm down medication and the doctor said no. Can you believe him?’ They reported her.

Good for them. This is how the system is supposed to work.

And even worse.

The patient died!

Because of aspiration the patient suffered because they were fed under sedation. Which developed into aspiration pneumonia, which led to their death within the week. And having vital monitoring, including the pulse oximeter, turned off. The hospital was able to determine that the alarm parameters had been lowered, several times, before the unit was turned off.

Worst yet.

No rapid response was called when the patient started to de-sat because no one knew because of the monitoring equipment being disabled. I cannot fathom what was going through the nurse’s head. The patient suffered and nothing was done, except an amendment to the other patient’s chart that the ativan was not given, when it had been charted given at the time.

She has been charged with murder.

Why is this case different than that of RaDonda Vaught? Many reasons.

Because this nurse knowingly sought out and gave an unordered med. To give the patient ‘something special’ as she told her coworkers. Which was a sedative commonly used prior to surgery. She stepped out of the scope of practice lines, was unsatisfied with the no she received from the doctor, took medication from another patient, gave the unruly patient what she thought they needed. And the patient aspirated and died. And she tried to cover it up. Worlds apart from the swiss cheese mistake that RaDonda Vaught was involved in.

This nurse also has an immediate temporary suspension of her nursing license. I hope she loses it for good.

There are guardrails of the scope of practice for a reason! Stay in your lane, people!

Let’s not forget the real victim here. The patient who died, and the family who lost them.

I was ready to be outraged on the nurse’s behalf. Until I read more about it. It is so easy to blindly follow the mad.

Now I am outraged on the patient’s behalf. This was unconscionable.

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