Facts: On April 26, the patient was admitted to the hospital suffering from a severe headache. Her physician ordered a CT scan for the following morning and prescribed Demerol and Disarmament to alleviate pain. Referring to the patient's medical chart, the nurse stated in her deposition that the patient had received injections of Demerol and Disarmament at 6:45 pm and 10:00 pm on April 26th.

The nurse checked on the patient at 11:00 pm. The patient's temperature and blood pressure were taken at midnight. Her blood pressure was recorded at 90/60, down from 160/80 at 8:00 pm.

At 12:25 am, 2 hours and 25 minutes after her last medication, the nurse administered another injection of Demerol and Disarmament because the patient was still complaining of pain. Although hospital rules require consultation with a patient's admitting physician when there is a question regarding the administration of medication, the nurse stated that she did not call the physician before administering another injection.

At 4:00 am. When the nurse made an hourly check of the patient, she discovered that the patient was not breathing. She issued a Code 99 (an emergency signal for a patient in acute distress). An emergency department physician responded and revived the patient. The patient was diagnosed as having suffered "respiratory arrest, with what appears to be hypoxic brain injury." CT scans revealed no bleeding, but other tests "revealed a grossly abnormal EEG with diffuse and severe slowing."

The patient was transferred to a nursing facility where she apparently remained in a coma at the time of trial. The patient's daughter and husband filed a complaint against the hospital, alleging that the hospital had been negligent in monitoring and medicating the patient, in failing to notify a physician when her vital signs became irregular, in failing to properly assess her condition and intervene, and in failing to exercise reasonable care. Later, the complaint was amended to include the nurse. The defendant nurse filed a motion for summary judgment. She asserted that, as a matter of law, she was shielded from liability under the qualified immunity afforded public officials engaged in their performance of discretionary functions. The circuit court denied the motion and the nurse appealed.

Issue: Is a nurse employed by a county hospital shielded by public official qualified immunity from a medical negligence action brought against her individually? How do you think a court would rule on this question? Explain your reasoning.

Questions:

Do you agree that the nurse should not be shielded from liability on the basis that she is a public official? Explain.

What assessment and reassessment issued do you see in this case and describe the importance of patient assessment and documentation.

Should the dramatic change in the patient's blood pressure have signaled a need to notify the attending physician of the patient's change in health status? Explain.

Was the nurse practicing medicine when she administered the second injection without contacting the attending physician?

Was it important for the nurse and the physician to collaborate the patient's status? Explain why.