Last spring,  Banner Health took action against an Arizona nurse who counseled, even encouraged, a prospective transplant patient about hospice care.  With 6 years of nursing under her belt, the nurse (whom I’ve declined to name),  identifies herself as a nurse specializing in cardiology, geriatrics, and end of life/palliative care. In the wake of her dismissal from the hospital, and loss of her nursing license, thanks to blogs and online communities throwing her support, she’s now been dubbed a patient advocate.  As of January 2012, at the request of the Arizona State Board of Nursing, she’s scheduled to undergo a psychiatric evaluation.

In the nurse’s own words: “I had discovered (patient) had no clue about what they were about to participate in when they agreed to get a major invasive surgery. When I properly educated the patient using the allowed materials by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care).”

In a typical medical practice, or hospital – it would be the doctor or surgeon, the one with the medical degree, who would be responsible for educating the patient about surgery.  Nurses are trained, and hopefully well trained.  They are not, however doctors, or surgeons. While nurses, good ones anyway, forge relationships with patients, it is not the place of a nurse, with 6 years of experience, or 60 years of experience, to counsel a patient into hospice care, especially when the patient is scared or is lacking information about surgery. The surgeon is qualified to, and prepared to, explain thoroughly, as many times as necessary, any medical procedure a patient is undergoing. A surgeon will typically explain the surgery, and after care needs to the patient as well as the patient’s family.

Also worth noting is that there is procedure in place for initiating Hospice care. I am not affiliated with Banner Health, however, as is standard in most hospitals across the country, hospice care is not initiated by a nurse, and certainly not without the knowledge of the attending physician. I’ve been disillusioned by the huge outpouring of support the nurse has received. Not only do I have personal experience (that I share below) that’s shaped my opinion on this matter, I take offense to the supporters who have adopted the attitude that this nurse was fired because she upset the attending physician, and threatened the dollars attached to a transplant procedure.