By Debbie Moore-Black, RN
He was Ivy League. Med school. His dad was an MD too. They lived not to far from this small cliquish town. Daddy’s house was right around the corner. That “mini” mansion.
After successfully completing his residency, Dr. David became our ER physician. This was a big deal. A big fish in a little pond.
He had an aura. He easily smelt of money. He also had an arrogance about him.
Though he was new to our hospital, he would definitely be the top dog. Anything he told me to do I knew I had to comply.
I loved ER nursing . I was still an LPN working actively on my RN.
Us LPN’s know our place. We know our hierarchy. And I knew my place. I was there to serve, honor and obey.
I couldn’t wait to be an RN. Because as an LPN we were so limited. And I wanted so much more.
It was a Saturday. Around 0230. A young man came stumbling into the ER. He was obviously intoxicated.
We sat him down on a stretcher. He had that disheveled look. Dehydration.
Dr. David ordered stat labs. The phlebotomist came in and drew his labs.
The patient had an obvious look of electrolyte imbalance.
Low blood pressure. Heart palpations. Muscle twitching. Nausea, vomiting and diarrhea. The EKG monitor showed ST depression and prolonged PR intervals. A few PVC’s also.
And just as Dr David predicted, this patient had a dangerously low potassium. K+ was less than 2.4.
Dr David knew I was an LPN. But it was just me and him in this 6 bed ER. So whatever I legally couldn’t do, he would have to do it.
He drew up some potassium from a vial. I assumed he was going to mix this in a mini bag.
I was certified to start IV’s. And so I did. LPN’s were never allowed to give any medication IV push though.
Dr. David never put the KCL in a mini bag. He had the KCL in a syringe and he ordered me to give the potassium IVP.
He said as long as he watched me I could do it.
In front of the patient, I told Dr. David that we could not give this patient KCL IVP (potassium chloride IV push). And he said then he would do it himself.
I became frantic. And in a firm voice I told Dr. David “you can not give a patient KCL IVP. You will kill this patient”. Dr. David got the syringe and put it into the IV port. He was getting ready to inject into this patient. I immediately squeezed the tubing in half. So the KCL couldn’t go through. And I repeated myself “you cannot give the patient KCL IVP.
It will stop the patient’s heart. You will kill the patient”.
Dr. David stopped. Starred at me with his glaring eyes. And said “fine, have him admitted to the medical floor. Let those Doctors deal with this patient”.
This was in the late 1980’s.
I learned a valuable lesson that night.
That whatever hierarchy ladder we stand on in healthcare, we all have a responsibility. A responsibility to ourselves, to fellow healthcare family and most importantly a responsibility to our patients.
Knowing that I was only a rung on this ladder…. But had I not spoken up and bent that IV tubing…. That patient would have most likely died.
Dr. David was angry that I defied his authority.
Arrogance sometimes can be quite dangerous.
Today, 2022, the NC Supreme Court ruled that nurses can be held liable for medical errors or mistakes- even if they were carrying out the Doctor’s orders.
Do Not Resuscitate 