thing takes a
Should the clinician have
kept silent when asked
about the treatment
a patient was receiving?
BY ANN W. LATNER, JD Mrs. W needed a new treatment plan, but the
Ms. E had spent the past 20 years as a nurse Ms. E attempted physician was unresponsive to Ms. E’s attempts
practitioner. She was hired ﬁve years ago by to contact to contact him. As the days went by, the patient
a midsized nursing center in her community. the physician continued to decline and Ms. E’s anxiety over
Within a year, she had been promoted to the the situation grew.
job of Care Plan Coordinator and was respon- several times, Ms. E was not the only person who was con-
sible for managing medical care and treatment but he would cerned. The patient’s adult son, who expressed
of all patients in the facility. One of the new not return her great alarm over his mother’s situation,
responsibilities that came with the promotion approached her one afternoon.
was the supervision of less experienced nurs-
phone calls. “What should we do?” he asked Ms. E. “I’m
ing staff. Ms. E thrived in her new position worried about my mother. She has lost so much
and received high ratings from her superiors. weight over the past few weeks, and she is
Everything went well until the day that doing agitated and hallucinating. There is deﬁnitely
the right thing turned out to be the wrong thing something wrong with her.”
for Ms. E’s job security. “Yes,” replied Ms. E. “I am worried about
Mrs. W, aged 76 years, had been exhibiting her condition.”
disturbing symptoms over the past two weeks, “What do you suggest we do about it?” asked
including hallucinations, weight loss, psychiatric Mrs. W’s son.
symptoms, and acute distress. Ms. E documented Continues on page 50
and reported all of the patient’s medical difﬁ-
culties to the staff physician. She attempted to
Cases presented are based on actual occurrences.
contact the physician several times, but he would Names of participants and details have been changed.
not return her telephone calls. Ms. E became Cases are informational only; no speciﬁc legal advice is
increasingly concerned as the patient’s condi-