Friday, February 11, 2011

Man Up!

A nurse in Minnesota has been accused of stealing narcotics from a patient during a surgical procedure. Sarah Casareto was giving conscious sedation to a patient during a nephrostomy tube placement when the patient started complaining about severe pain. Ms. Casareto told the patient she could not give him too much narcotics and to "man up". She tried to soothe the patient by saying "go to your beach...go to your special place." Ha ha. That is a good one. The pain was so intense the staff had to physically hold him down to finish the procedure.

The operating room staff noticed Ms. Casareto was slurring her words and unsteady. They even noticed she was falling asleep in the procedure room. She had checked out 500 mcg of fentanyl (!) for the procedure but had given the patient only 150 mcg. For some reason, it was not mentioned in the article, the patient contacted the police after his excruciating procedure. That's when Ms. Casareto refused a drug test and resigned.

It's sad for the patient that he had to go through such torture for a pretty simple and routine procedure. It's worse that the doctor doing the procedure didn't suspect something was wrong when the patient had to be physically restrained on the operating room table because he wanted to get the heck out of that torture chamber. But it seems unconscionable that if the patient was experiencing so much discomfort that the staff didn't call somebody else in to assist with pain control and sedation. The doctors noted that this procedure normally isn't that painful. But when it is for this patient, it baffles me that they didn't do something about it instead of just holding him down while a clearly intoxicated nurse was falling asleep instead of watching the patient. There were no anesthesiologists around that could give an urgent assist to the operating team? How would any of those people like to have a large catheter jabbed into their kidneys while being held down against his will. Sounds like some torture routine from an Iranian prison. Clearly Ms. Casareto has a lot of explaining and cleaning up to do. But the staff,who were not under the influence of narcotics, also need to clear things up with the patient, the hospital, and the police as to why they allowed this battery of the patient to continue.

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