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Retired GP assists rest home resident in emergency (06HDC15897)
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(06HDC15897, 20 April 2007)
Rest home and hospital ~ Registered nurse ~ Retired general
practitioner ~ Bowel impaction ~ Manual evacuation ~ Duty to
respond in emergency ~ Medical emergency ~ Practising certificate ~
Privacy ~ Scope of practice ~ Vicarious liability ~ Rights 4(2),
An 87-year-old terminally ill man resided in the hospital care
ward of a rest home, where he required full nursing care.
When a caregiver found the man distressed she contacted the
registered nurse on duty, who examined him and concluded that he
had faecal impaction. Rather than consult other staff on duty in
other parts of the hospital, the nurse asked a retired GP, who was
visiting a relative, to review the man. The GP concurred with the
nurse's assessment and, with her assistance, successfully performed
a manual evacuation of the man's bowels.
The manager of the rest home became aware of what had happened
and complained to HDC.
It is a doctor's duty to attend in an emergency. In this case,
the GP was retired and no longer held a current practising
certificate. He was a visitor at the hospital. However, the expert
advisor in general practice advised that he still had a duty to
respond to a situation presented as a potential medical emergency.
Furthermore, his clinical care was exemplary. While it was not
ideal for a retired doctor to be called on to administer medical
treatment during a visit to a rest home on personal business, these
circumstances were outside his control. He simply responded as a
"good Samaritan", and did not breach the Code.
The nurse also had good intentions, and was clearly concerned
for her patient. But the errors she made were serious. In failing
to discuss the man's predicament with the other registered nurses
on duty, she failed to co-operate with her colleagues to ensure
quality and continuity of services to her patient, and therefore
breached Right 4(5). By failing to document the retired GP's
involvement, and by failing to safeguard the patient's privacy, the
nurse did not comply with professional standards, and breached
It was also found that the nurse was working outside her scope
of practice and she was inadequately supervised. Therefore her
employer, the rest home, was vicariously liable for her breaches of