Criminal Prosecution for Nursing Practice

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Case Study:

Until recently, the risk of criminal prosecution for nursing practice was nonexistent unless nursing action rose to the level of criminal intent, such as the case of euthanasia leading to murder charges. However, in April 1997, three nurses at the Centura St. Anthony Hospital, outside of Denver, were indicted by a Colorado grand jury for criminally negligent homicide in the death of a newborn. Public records show that one nurse was assigned to care for the baby. A second nurse offered to assist her colleague in caring for the baby. A third nurse was a nurse practitioner in the hospital nursery. Because the baby was at risk for congenital syphilis, the physician ordered that the nurses give 150,000 units of intramuscular penicillin, which would have required five separate injections.

In relation to other problems the same day, the baby was subjected to a lumbar puncture, which required six painful attempts. To avoid inflicting further pain, nurse two asked the nurse practitioner whether there was another route available for the administration of the penicillin. Nurse two and the nurse practitioner searched recognized pharmacology references and determined that intravenous administration would be acceptable. The nurse practitioner had the authority to change the route and directed nurse two to administer the medication intravenously rather than intramuscularly. Unrecognized by the nurses, the pharmacy erroneously delivered the medication, prepared and ready to administer, in a dose ten times greater than was ordered—1.5 million units. As nurse two was administering the medication intravenously, the baby died. The Colorado Board of Nursing initiated disciplinary proceedings against nurse two and the nurse practitioner, but not against nurse one. The grand jury indicted all three nurses on charges of criminally negligent homicide but did not indict the pharmacist (Calfee & Plum, 1997).

Respond to the following with these headings:

• Identify what emotions are evoked as you consider the Colorado Board of Nursing case stated above?
• Should the courts take into consideration the fact that the nurses’ error occurred because they wanted to avoid causing the baby unnecessary pain? Discuss your thinking.
• Can you think of other occupations in which the consequences of unintentional errors have greater legal implications? Discuss your answer.
• How should the nursing profession respond to this frightening new legal threat?
• Which sections of the State Nurse Practice Act did the nurses violate?