[rmah]

The NP did not try to do the right thing. Given the facts outlined in the article, a qualified medical professional would have sent the patient to a hospital (emergency room) regardless of the opinion of the consulting MD's who did not see the patient. Why? Because the NP did see the patient. Why take an off the cuff opinion of a MD who hasn't examined the patient or seen his charts (all info was given verbally over the phone) as absolute? Note, many seem to interpret the refusal of admission as an inability to go to a hospital, that is not the case. The emergency room was still available.

IMO, there was failure at all levels. The NP failed, the consulting doctors failed, the hospital chain failed. Systemic failure.

[olliej]

Except they all seem to be part of the same company so I assume they have rules saying that the NP needs to give the Dr’s opinion more control over the decision. After all it sounded like they contacted multiple (of the company’s) drs and they said the same thing.

If they are part of the same network the dr probably had access to the charts, and if not I assume nurses who are required to call doctors can communicate the content of a chart.

It also makes no sense to say: NP you are required to contact a doctor to get permission to admit a patient, but if you think the doctor is wrong you should admit them anyway. If that isn’t the rule then you should save money by not having drs who only exist to answer the phone and trust you NPs to admit patients who need it.

[dragonwriter]

> Why take an off the cuff opinion of a MD who hasn't examined the patient or seen his charts (all info was given verbally over the phone) as absolute?

While it doesn't change the overall point much, she didn't take the opinion of an MD that way; after getting the response from yhe hospitalist, she attempted to bypass the refusal by taking the case to a physician at her own clinic who had admitting privileges at the hospital, but who reached the same conclusion as the hospitalist had.

[closetohome]

The nurse was sued as well -- but I agree, she's just as liable as the doctor.