Yes I have.
This happened in an Army Medical Center when I was an Army nurse. They had
resident physicians there that had graduated from med school and who were
making their rotations through different patient care areas of the hospital.
I
had a patient who was having cardiac arrhythmias due to the fact his serum
potassium level was low. The doctor gave me a verbal order to place some liquid
potassium in a syringe and to inject it directly into his IV line through the
injection port. I told the doctor I refused to do that because it was not a
safe thing to do. Potassium is never injected with a syringe into an IV line.
It would kill the patient causing cardiac issues. The doctor should have known
this. Well the doctor told me, “I am the doctor and I decide what is necessary
for this patient.” I told the doctor, “well I am the nurse and I am telling you
I refuse to comply with that order because it is not medically safe to give the
patient potassium in that manner”. I never gave the patient the potassium as the
doctor had ordered.
In
a short while, that doctor came back and told me he had to apologize to me and
he admitted I was right to refuse his order. He obviously went to his
overseeing doctor and discussed the matter and was probably told he needed to
come apologize to me because I was right.
I
will say as a nurse, I have definite medical and legal standards I have to be
aware of and know for the patient’s well being and to protect myself and my
nursing license from standard of practice violations. This case is a classic
example of that. Had I complied with the doctors order and given that patient
the potassium IV push, I would have been as wrong and in hot water as well as
the doctor.
An
order was written for an IV drip bag of potassium chloride to be slowly
administered to the patient to bring his serum potassium level back into normal
standards and that was attained in the proper manner.
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