Why didn’t nurses stop unsafe practices?
To the editor:
I have practiced nursing for more than 30 years. The recent events at the Endoscopy Center of Southern Nevada have been the dinner table (and breakfast and lunch table, for that matter) topic of discussion since the story was first reported. What my family continues to ask, and what I have struggled to understand, is how medical and nursing professionals could have let such poor infection-control practices continue for so long.
It is not for me, a nurse, to address the absence of medical practice standards for physicians. I must, however, address those of nurses who practice under the same Nevada law that I practice under. The provisions of the Nevada State Nurse Practice Act are clear. The unsafe infection-control practices at any medical facility are a mandated reportable event and should have been reported at the first incident [NRS 632.472 Provision 1. (a)].
It was reported by Las Vegas Mayor Oscar Goodman at a news conference announcing the closing of the endoscopy center that some of the nurses working at the endoscopy center claim they were ordered to perform the unsafe practices in question. Based on the act, such a claim is moot: A registered nurse may refuse an order if she takes appropriate action to ensure the safety of a patient.
This portion of the statute specifically addresses the administration of medication. Nurses, especially registered nurses, are trained from the beginning that it is the responsibility of nursing to advocate for the safety of their patients in all situations where that safety may be at risk. Provision 3 of the American Nurse Association Code of Ethics states, “When the nurse is aware of inappropriate or questionable practice in the provision or denial of health care, concern should be expressed to the person carrying out the questionable practice. Attention should be called to the possible detrimental affect upon the patient’s well-being or best interests as well as the integrity of nursing practice. When factors in the health care delivery system or health care organization threaten the welfare of the patient, similar action should be directed to the responsible administrator. If indicated, the problem should be reported to an appropriate higher authority within the institution or agency, or to an appropriate external authority.”
Further, it is the nurse’s legal responsibility to “create a safe and effective system for delivery of nursing care which complies with nationally recognized standards.” The infection-control standards that are relevant to these incidents at the Endoscopy Center of Southern Nevada are some of the most basic of recognized national standards.
The days when nurses could claim that their practice was guided by the order of a physician or administrator without regard to the ethical standards of nursing practice are long gone. Nursing is a unique discipline, responsible for the advocacy of the safe and ethical treatment of members of the communities in which we serve.
Most nurses do this very thing. Thousands of nurses in Nevada advocate for their patients each and every day. It is imperative that the members of the community hold the nurses that provide them care accountable for this charge. Nurses hold a unique position in the American health care delivery system, with specialized knowledge and the legal obligation to assess the safety of health care delivery and advocate for safe health care practices.
Carrie Krumtum
PAHRUMP
Ironic apology
To the editor:
Am I the only one who found it ironic that “Dr.” Dipak Desai would spend the money he gained by infecting patients with hepatitis C on a full-page ad in Sunday’s Review-Journal apologizing for infecting them with hepatitis C?
As a patient at one of his endoscopy clinics, I would have preferred a Hallmark card: “Sorry I gave you AIDS, but I really had to save $2.43 on that syringe.”
As for the apology, he can shove it where only one of his colleagues can find it. As for the penalty for this heinous crime, why aren’t any officials calling for criminal prosecution? This is reckless endangerment — 40,000 counts. I only pray it doesn’t turn into manslaughter.
B. Atwell
LAS VEGAS
Poor judgment
To the editor:
I cannot believe you would publish a large, color picture of a man grabbing his wife’s breast (Week in Review, Sunday). Of all the news that is out and about, stories waiting to be told, you put that in? What were you thinking?
Carol Vick
OVERTON
