The thin red line

pope-scope2As nurses, we walk an ethical tight rope between what’s legal and what’s right.

In the case of Pope Francis, his nurse acted outside her scope of practice; she went against physician orders and did what she thought was right, and acted appropriately.

It’s unclear if the nurse’s actions led to a better overall outcome, saving his life, but it raises the question: should we go against orders and do what we think is best, even if it could cost us our jobs?

I’ve wanted to write about this topic for a few months. I didn’t do it for a couple reasons:

  1. I didn’t want to open Pandora’s box.
  2. I didn’t want to incriminate my friends, former colleagues, and current colleagues.

A few days ago, after I read the Pope’s words, I’ve now reconsidered. I do think it’s worth talking about, even if it might make people uncomfortable.

“I am alive because of one of them. When I went through my lung disease at the hospital, the doctor gave me penicillin and streptomycin in certain doses. The sister who was on duty tripled my doses because she was daringly astute; she knew what to do because she was with ill people all day. The doctor, who really was a good one, lived in his laboratory; the sister lived on the frontier and was in dialogue with it every day.” – Pope Francis

So, in my hunt for the truth, I’ve put some my friends, former colleagues, and colleagues on the spot by asking them: In the past, have you ever gone against physician orders and, you know, practiced medicine without a license?

As you can imagine, I didn’t get a straight yes or no, but I did get a feeling some crossed the line.  A friend and former coworker did tell me that he’s administered more than the allotted dose of pain medications when the ordering physician refuses otherwise.

I don’t know what the medication was, but I got a feeling it was a narcotic.

I’m not going to support practicing without a license, but I know it happens, especially when we know our patients are suffering needlessly and we can’t get anyone to do anything about it.

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