There was an interesting story out of Illinois this week: according to the Chicago Tribune site, a nurse was arrested in a Chicago ER because she “disobeyed” a police officer’s orders to take blood from a patient who had been brought into the ER but was not yet registered as a patient.

The nurse is suing the city and experts are saying she is very likely to win. While there are two sides to every story, this encounter seems like a clear case of bullying. Especially since the nurse was not actually refusing to take the blood, she only said she would need to talk to her supervisor first.

When I doing my clinical rotations in a hospital in Philadelphia, we would often have post surgical patients who were in police (or department of corrections) custody. Some would simply have a police officer sitting in the room with them, but others were actually handcuffed to the bed. Of course it’s darn near impossible to make an occupied bed when the person is chained to its frame, but there are bigger problems with this practice: in a code the patient would not be able to be properly cared for until they were released.Eventually the hospital practice changed and the use of metal restraints was prohibited.

While there are certainly safety issues for the law enforcement person in charge, other patients and the public at large, (and I certainly I don’t want to be hurt by a violent patient) the issue itself brings up an important ethical concern for nurses. We are supposed to be advocates for our patients, but not all our patients are 8 year olds with angelic eyes and a sweet personality. Some of our patients are difficult, some are even criminal. Making sure that they have good care is perhaps even more necessary (not more important, just more needed) than when we work with easier, more compliant patients.

It’s important, but hard. Dealing with emotions that come up when caring for these type of patients will the subject of my next post.