Ask A Nurse Attorney, April 2009
Nurses, welcome to “Ask a Nurse Attorney”. This section designed for licensed nurses. If you have a question to a nurse attorney and would like to have them answered, please feel free to e-mail Lorie@brownlaw1.com. If your question is selected, it will appear in the upcoming issues of Nursing Focus.
Dear Nurse Attorney:
I am a registered nurse in the ISNAP program. I am still able to use narcotics with a short half-life and still be in compliance with my ISNAP contract. I really want to get clean, however I’m concerned that if I discuss my usage with ISNAP, I will get in trouble with the board.
Addicted RN
Dear Addicted RN,
Indiana State Nurses Assistance Program (ISNAP) understands that addiction is a disease and that relapses are a part of the process. ISNAP is more than willing to work with you if you are still using to assist you in getting the help you need to live a clean life. However, if you do not inform ISNAP that you are still using and do not get the help you need and you are caught and charges are filed against your license, the board will take very serious action. Therefore, if you would like to protect your license, I suggest that you inform ISNAP of your relapse and get the help you need. Therefore, you are more likely to protect your license.
Lorie A. Brown, R.N., M.N., J.D.
Dear Nurse Attorney:
At the hospital where I work, I witnessed a physician override a family’s request for a Do Not Resuscitate Order for their loved one. I reported this to the hospital’s ethics committee and the decision was that a physician could do this. I am very concerned if this is legal and under what circumstances can a physician override a DNR order.
No Code
Dear No Code,
There is a difference between an advanced directive and a Do Not Resuscitate Order. An advanced directive comes into play when an individual has a terminal condition in which death is imminent and does not want to be kept alive by life support. However, a physician still must write a Do Not Resuscitate order. A physician is not required to write a Do Not Resuscitate order if death is not imminent. In Indiana, there are five people who can make a determination regarding life prolonging procedures if there are no advanced directives:
the physician, the spouse, clergy, adult children, and siblings. The court will take into consideration the point of view of all these individuals in determining whether life prolonging procedures should be continued or discontinued. However, in short, it is appropriate for a physician to override a family’s request for Do Not Resuscitate order if there is no advanced directive if he is basing his order on communications with the patient before the patient became unable to make decisions on his or her own behalf.
Lorie A. Brown, R.N., M.N., J.D.
“ASK A NURSE
ATTORNEY”
Lorie A. Brown, R.N., M.N., J.D., of Brown Law Office, Indianapolis, Ind., (317) 465-1065, is a practicing nurse-attorney who represents nurses for licensing issues before the Board and for contracting matters. The views expressed in this column are those of the author. www.EmpoweredNurses.org.
