Nurses Fired For Giving Anesthetic Without Doctor's Order - wave3.com-Louisville News, Weather & Sports

Nurses Fired For Giving Anesthetic Without Doctor's Order

(LOUISVILLE, Ky., Saturday, October 4, 2003) -- Nurses on two units at a Louisville hospital illegally sedated patients with an anesthetic without a doctor's order, a practice that is outside the scope of a nurse's license, the hospital said.

Norton Audubon Hospital said Friday it had fired 14 nurses and disciplined nine others after learning of the practice.

An internal review found no patient had been harmed, the hospital said.

The medication involved is Diprivan, a short-term, fast-acting sedative that is commonly used to comfort patients who are on respirators, a machine that helps them breathe. Nurses call it "mother's milk" because of its calming effect on respirator patients, who can become agitated and try to pull the machine's tube out of their throat.

"If you're waking up with that tube down your throat, you start coughing. It's just very uncomfortable for you," said Cis Gruebbel, vice president for patient-care services at Audubon.

The hospital routinely monitors complication rates, mortality rates and infection rates, and reviews any adverse outcomes, said Dr. Dan Varga, chief medical officer of Norton Healthcare.

"We see nothing on the affected units that is different from comparable units within our hospital," he said.

Kentucky Board of Nursing standards, which have the force of law, make clear that it is beyond the scope of a nurse's license to administer anesthesia without a doctor's order, according to a statement released by the hospital.

"We have proven by our actions that we have no tolerance for noncompliance," Gruebbel said, adding that the 14 fired nurses had clearly gone beyond what they are permitted to do.

The hospital has notified the Board of Nursing of the matter, and it will conduct its own review, the hospital said.

Gruebbel said she did not know how many patients had been given the sedative without a doctor's order, nor over what period of time. And citing employee confidentiality, she refused to identify the units involved.

"It evidently has been a longstanding practice," particularly on the 11 p.m. to 7 a.m. shift, said Gemma Ziegler, vice president of the Nurses Professional Organization, which is trying to unionize the hospital. Ziegler said she had spoken with two of the dismissed nurses, including one who had worked at Audubon for 18 years.

"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 was upset that the hospital felt it had to fire the nurses. "I don't condone giving medicine without a doctor's order," she said, but added, "My God, to throw away these experienced nurses is just crazy."

Gruebbel said she learned of the practice late last month from the manager of one of the units. She said she immediately began an investigation.

She said the hospital is holding meetings and incorporating reminders into staff training programs for its 473 nurses and other licensed practitioners that they must stay within the scope of their practice.

(Copyright 2003 by The Associated Press. All Rights Reserved.)

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