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“ Nurses Refuse to Follow Orders: Catastrophic Results”CASE ON POINT: Szczuvelek

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“ Nurses Refuse to Follow Orders: Catastrophic Results”CASE ON POINT: Szczuvelek v. Harborside Healthcare Woods Edge, 2005 WL 123829A.2d–NJISSUE: Most nurses are keenly aware of the importance of “following doctor’s orders.” And they do. However, in this extraordinary New Jersey case, nurses not only failed to follow doctor’s orders but refused to follow a nursing home’s orders regarding the suctioning of a patient. Even after being confronted with their failure and refusal, the nurses stonewalled the friend of a patient who spoke with nursing home officials regarding the failure. The nursing home may have avoided liability because the statute of limitations had run. However, the harm that resulted from the nurses’ failure to follow orders was irreparable.CASE FACTS: In February of 1999, Eugene Burns was admitted to Robert Wood Johnson Hospital (RWJH) in New Brunswick for treatment of an aneurysm During surgery, a tracheotomy tube was inserted into the patient’s throat. Consequently, he was unable to speak. He communicated by writing on a note pad. The patient remained hospitalized for two months following his operation. On April 13, 1999, he was transferred to Harborside Nursing Home for rehabilitation. The medical order issued by the hospital directed that the patient be suctioned every four hours. Harborside issued its own order on April 14, 1999, requiring healthcare personnel to “suction Q shift and PRN.” Stephen Szczuvelek, a close friend of the patient, visited him at the nursing home on April 15. During the visit, the patient wrote him a note stating “Steve, you have to get me out of here. They’re going to kill me. They left me in my own waste for three hours. They won’t suction me. Please get me out of here. And I need to be suctioned now.” Szczuvelek pressed the nurses’ call button to obtain help but did not receive a response. After waiting an hour, he left the patient’s room seeking help. He found a nurse who took him to a conference room to speak with a social worker. After he gave the patient’s note to them, they assured him that “‘someone would assist the patient.” Upon returning to the patient’s room, Szczuvelek asked the nurse on duty if she would suction the patient, she responded, “I just did.” The patient shook his head indicating “No.” Szczuvelek confronted the nurse, “Ma’am, I am here almost two hours and you have not stepped foot in this room.” She responded, “It’s the doctor’s orders, he’s not to be suctioned.” Upon further prodding from Szczuvelek to suction the patient, the nurse said, “I don’t have to take this crap,” and left the room. Szczuvelek left the nursing homethat evening concerned about the patient and determined to find an alternative placement for him. The following day, the patient was rushed to Somerset Medical Center. He was unresponsive. Szczuvelek visited the patient in the hospital’s emergency room. While he was in the emergency room, a nurse informed him that the nursing home had not suctioned the patient because there was a fire drill the prior evening. Later the social worker at the nursing home denied there was a fire drill. A physician at the hospital asked Szczuvelek why the patient was not transferred to RWJH. The physician was concerned since the patient had previously been treated at RWJH, and his medical records were there. On April 17, 1999, the patient had a heart
attack and died. Szczuvelek filed suit against the nursing home and the hospital two years and nine days after the patient’s death. Later, on June 24, 2001, Szczuvelek received a report from Dr. Warren Widmann, a medical expert, who concluded that the patient had lapsed into a coma and died as a result of inadequate medical care by the nursing home and the hospital. The trial court granted the defendants’ motion for summary judgment on the grounds that New Jersey’s two-year statute of limitations barred the plaintiff’s claim. The plaintiff appealed. The Appellate Division affirmed the judgment of the trial court. The plaintiff appealed.COURT’S OPINION: The Supreme Court of New Jersey affirmed the judgment of the lower court.LEGAL COMMENTARY: The nurses who failed to follow the orders to suction the patient “every four hours” were guilty of the most reprehensible form of misconduct. Thenursing home’s orders to suction the patient at least once on each shift, was in sharp contrast to the hospital’s order. However, even that order was not followed. To add insult to injury, the boldfaced lie and comments of the nurse with whom the patient’s fried last had contacted is almost inconceivable. Yet, it happened
COPYRIGHT 2005 Medical Law PublishingNo portion of this article can be reproduced without the express written permission from the copyright holder.Copyright 2005 Gale, Cengage Learning. All rights reserved.
Week 12: Discussion
1) From this module, read “Nurses refuse to follow orders” document.
2) Answer the following questions:
• What is your reaction to this article?
• What was the issue in the article?
• What was the final outcome?
• If you were the hospital administrator, what are two things you would do? Firing employees is not an answer.
You need to include a reference and in-text citation(s) in APA in your initial post

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