Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

As a registered nurse, I do not want to violate my patients’ rights anymore

Beth Anne Algie, RN
Conditions
February 15, 2020
94 Shares
Share
Tweet
Share

I am a critical care RN, and I violated my patients’ rights. For decades, every day that I worked in the emergency department or the intensive care unit, I violated my patients’ federally protected rights to participate in their plan of care.

I didn’t mean to, or want to, but my tasks to maintain their life took priority over the obstacles to hearing them when they could not speak.

Almost every day of my career, I took care of awake and intubated patients with a tube through their vocal cords and with hands too weak, too injured, too full of tubes and equipment, or too swollen to write.  Or I took care of stroke victims, unable to form the words with their mouths.

My adult patients have a right to communicate their request, consent or refusal of any treatment. They have a right to ask questions of a provider before consent. They have a right to change their advanced directives. They have a right to direct which visitors they want to see.  They have a right to describe their discomforts, both physical and emotional, so that I could address them.  They have a right to file a grievance. They have a right to ask for a clergy, even when their record says they are an atheist.

Sometimes, they just wanted to tell their family that they loved them one last time.

But I violated those rights.  I did not provide the means of communication that their condition required. I evaluated their vital signs and neurological signs and injuries, but had little time to guess at their questions.  When I could, I tried to anticipate their questions, and spent hours guessing.  They often fatigued before I guessed correctly.  I tried.

Some competent, but non-verbal patients wanted to change their directives for end of life.  By not hearing their new choices, or by not informing them of choices in response to their questions, we assaulted them in their last hours.

If they spoke another language, and I did not provide an interpreter, or needed TTY or braille and I did not provide those, or if they could write and I did not provide pen and paper, I would be in violation of federal law. But if they needed a different technology to address another communication difficulty, I ignored them. The resources did not exist until recently.

There are now technology devices to allow patients to “type” on a computer screen by just looking at the screen.  Each phrase they look at is recorded by the device.  Each letter they type is recorded.  There are fields to ask to confirm their choices.  There are screens to assess their cognitive ability and orientation, which would not only meet their needs, but give me better assessment quality. (Stephen Hawking communicated on such a personal device.)

With these devices, patients can use a call bell, choose a pain level, ask any question they want, and participate in their plan of care – all with their eye movements.

I applaud all those technology companies developing those devices for hospital use, and I demand these are available for my patients.  As a registered nurse, I do not want to violate my patients’ rights anymore.

Beth Anne Algie is a nurse. 

Image credit: Shutterstock.com

Prev

Intelligence does not protect against the worst of life's cruelties

February 15, 2020 Kevin 0
…
Next

Physicians are excellent at floccinaucinihilipilification. What is that?

February 15, 2020 Kevin 0
…

Tagged as: Critical Care, Hospital-Based Medicine

Post navigation

< Previous Post
Intelligence does not protect against the worst of life's cruelties
Next Post >
Physicians are excellent at floccinaucinihilipilification. What is that?

Related Posts

  • Registered nurse for president!

    John Green, DHA, RN
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • A love letter to patients

    Marcie Costello
  • Patients are not passengers

    Christopher Noll, RN, MSN
  • Expensive Medicare patients aren’t who you think

    Peter Ubel, MD

More in Conditions

  • Overcoming Parkinson’s: a journey of laughter and resilience

    Cynthia Poire Mathews, FNP
  • The untold struggles patients face with resident doctors

    Denise Reich
  • Maximize sleep efficiency with stimulus control

    Pedram Navab, DO
  • The endless waves of chronic illness

    Michele Luckenbaugh
  • Surviving and thriving after life’s most difficult moments

    Rebecca Fogg, MBA
  • The surprising power of Play-Doh in pediatric care: How it’s bringing families together

    Alexander Rakowsky, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming Parkinson’s: a journey of laughter and resilience

      Cynthia Poire Mathews, FNP | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Can COVID Lead to Diabetes?
  • Caplyta Success in Major Depression; Mental Illness and Aging; New PTSD Device OK'd
  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Pre-Existing Heart Failure Tied to Higher Mortality in Lymphoma
  • Providing Abortions in Alabama; FDA's Formula Woes; Unread Claims Rejected

Meeting Coverage

  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Less Abuse With Extended-Release Oxycodone, Poison Center Data Suggest
  • Novel Strategies Show Winning Potential in Ovarian Cancer
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming Parkinson’s: a journey of laughter and resilience

      Cynthia Poire Mathews, FNP | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

As a registered nurse, I do not want to violate my patients’ rights anymore
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...