Conflicts between doctors and nurses are a part of medical care. While the physician may be ultimately in charge of the course of treatment, the nurses who work with the patient daily may disagree about the patient's needs. When conflicts arise that compromise a patient's health, can a nurse be disciplined for failing to follow a doctor's dangerous order?
Follow Orders or Protect Patients?
Nurses work with their patients for hours at a time, day after day. In contrast, their physician may only see them for a few minutes. As a result, it's not uncommon for nurses to catch mistakes that doctors may make. A doctor may forget that a patient is on a certain medication or had a certain treatment before prescribing a new one. In those types of cases, a nurse needs to contact the doctor, talk through the mistake, and make sure the patient isn't harmed.
In most cases, however, a nurse can't unilaterally disregard a doctor's orders. The nurse has a responsibility to speak to the doctor, speak to colleagues, and escalate the situation as necessary to managers or other physicians. What the nurse cannot do is decide the doctor is wrong and take whatever course of action they want.
When Orders Would Cause Harm
But what happens when disagreements about a course of treatment cannot be resolved? If a doctor orders you to do something that you know would cause a patient harm, do you have the right to refuse without jeopardizing your license? The answer, like many things in life, is that it depends.
Most state nursing boards will discipline a nurse that refuses to follow a physician's orders unless the nurse is doing so out of concern for a patient's safety or if the orders conflict with the nurse's own personal or religious beliefs. Even in instances where the orders might harm a patient, nurses still have an obligation to bring their concerns up their chain of command rather than deciding on their own about a patient's treatment.
However, there is some reason for nurses to be concerned about their own liability if they follow a doctor's dangerous or risky orders. In most states, only the doctor treating the patient is liable for medical malpractice if their treatment orders cause harm to a patient. A nurse following a doctor's orders generally wouldn't be liable in a malpractice lawsuit. But some states are changing these rules. The Supreme Court of North Carolina recently held that a registered nurse could be held liable for negligence and medical malpractice for following a doctor's orders that caused harm to a patient.
Discipline After Protecting Patient Safety
Whether or not a state's nursing board would discipline a nurse who disobeyed a doctor's orders is often dependent on the circumstances. If you are being investigated for disobeying orders, convincing the nursing board that you were acting in your patient's best interests can help you avoid discipline.
At the Lento Law Firm, our team of experienced license defense professionals understands how difficult it can be to make hard calls about patient treatment. Contact our office today by calling 888.535.3686 and learn more about how we can help you.
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