NR 395 Week 6 Hot Topic
New York Times
Nurses Strike in New York: Threat Increases Over ‘Safe Staffing’ Levels
... [Show More] (https://www.nytimes.com/2019/03/30/nyregion/nyc-nurses-strike.html?rref=collection%2Ftimestopic%2FShortages&action=click&contentCollection=timestopics®ion=stream&module=stream_unit&version=latest&contentPlacement=2&pgtype=collection®ister=google)
On March 30th, 2019, Patrick McGeehan wrote an article that focused on the major threat of the nursing walk out that was to occur in New York City Hospitals. In McGeehan’s article, he interviewed a nurse in the NICU, Shanna Murphy, who remembers an issue where she was taking care of a critical/unstable infant while a mother of a crying baby felt her child was being ignored.
ANSWER
In an article written by Richard Pérez-Peña titled Unneeded Drugs Killed Hundreds at U.K. Hospital, Inquiry Finds, it as been found that there were many unnecessary deaths related to misuse of pain medication. The article discusses a hospital in London that had found that “as many as 650 patients at a small British hospital died from overdoses of powerful painkillers that they did not need” (NYTimes, 2018). This issue has been going on during a time period from 1989 to 2000 where multiple doctors, but one identified specifically would order heroin “also called diamorphine” to patients who were not in pain or required milder pain relievers. The ordering of this form of pain management went through many levels of checking including the pharmacists who received the order/provided the medication to the floor, and the nurses who then administered the medication. There have been evaluations of medical records for thousands of patients who died at the hospital over the years and “found evidence of opioid usage without appropriate clinical indication in 456 patients, or more than 45 percent” (NYTimes, 2018). There were also charts that were missing records and clinical notes that could have been related to this issue. This form of medication was administered in an infusion pump that they called a “syringe driver” that continued to administer the pain medication to the patients in dangerous doses.
The clinical issue that I determined to be prevalent in this article from the NY Times was how this issue of unproper opioid ordering and administration for years, went through many steps and checks before actually reaching the patient, and there were no pharmacists or nurses that raised the question of whether or not this extreme pain medication was needed for these patients. I found this to fall under an ethical issue in regards to both pharmacists and nurses at this hospital not questioning orders given by a physician. Whenever there is an order that seems out of the ordinary or extreme for a patient, there should be questions asked to get a proper explanation from the ordering physician. One nurse at the hospital, Pauline Spilka was interviewed and basically said she had never heard of the syringe driver until working at this hospital, and she stated “[…] I do not recall a single instance of a patient not dying having been put onto a driver” (NYTimes, 2018). Following this quote, she says that she can not give a reason why she didn’t say anything about these orders during her time working at this hospital and how guilty she feels about this form of treatment that was ordered for these ill patients. With the current issues that are arising with opioids in the United States, this type of medication administration ordered by these physicians baffles myself, this type of medication is not even utilized for those in hospice care in my facility and it should’ve raised red flags to the nurses and pharmacists who read and acted on these orders.
References:
NY Times. (June 20, 2018). Unneeded Drugs Killed Hundreds at U.K. Hospital, Inquiry Finds Retrieved from https://www.nytimes.com/2018/06/20/world/europe/uk-hospital-deaths.html?rref=collection%2Ftimestopic%2FNursing%20and%20Nurses&action=click&contentCollection=health®ion=stream&module=stream_unit&version=latest&contentPlacement=2&pgtype=collection [Show Less]