One in 11 nurses responding to a non-scientific survey say they have intentionally given overdoses of narcotics to dying patients, according to the current issue of Nursing Life magazine.
In its July-August issue last year, the magazine had published 85 questions dealing with ethical dilemmas nurses may face. Of the approximately 165,000 of the magazine's readers, 5,085 responded.
Among the questions asked was: "Have you or anyone you know ever deliberately given an overdose of a narcotic to a dying patient with intractable pain?"
Eight percent of the 5,085 respondents said they have and would do so again. One percent said they have and would not do it again.
Sixty-one percent said they have not and never would administer such a dose, and 30 percent said they have not done so but might, under some circumstances.
Nancy Perrin, spokesman for the American Nurse's Association, said yesterday that she hoped that the figures would not lead to the belief that 9 of every 100 nurses are administering lethal injections of narcotics to patients.
"This is an opinion survey and not a scientific survey," she said, adding that in most such cases, nurses may have been ordered by doctors to administer the narcotics although the dose was abnormally high.
The sampling is not a random, scientifically valid poll such as those by professional polling organizations, said Maryanne Wagner, associate publisher of Nursing Life. But Wagner said she believes the large number of responses makes the results valid to some degree statistically.
Nurses comprise almost all of the magazine's readership, and almost half of them work in supervisory positions, Wagner said.
The survey also asked whether nurses, believing a doctor to be incompetent, would inform patients, if asked. About 33 percent of respondents said they would not.
Sixty-five percent said they would tell patients that, if uneasy, they could change doctors. Only 1 percent said they would reveal their beliefs about a doctor's competence.
The survey explored other questions about tensions between doctors and nurses regarding methods of treatment and found that, compared with respondents in a similar nursing magazine survey in 1974, nurses are more assertive, especially those newer to the profession.
Nurses are more willing to refuse or question doctors' orders than they were 10 years ago, according to the new survey. They also are more likely to tell review boards about errors they have seen doctors make.
The magazine also asked what a nurse would do if asked by a doctor to administer a drug dose the nurse knew to be incorrect after checking.
According to the survey, 48 percent would refuse to give the injection and tell the doctor to give it himself. Another 50 percent said they would report the incident to their supervisors, while 2 percent said they would administer the improper dose.
Respondents said they are less likely than those in 1974 to let elderly, comatose, terminally ill patients die without calling a "life-support" team.
When confronted with such a patient struck suddenly with cardiac arrest, 65 percent of respondents said they would call in an emergency life-support team unless a doctor had specified that the patient was not to be given treatment involving extraordinary life-saving measures. The 1974 survey showed that only 46 percent would summon a life-support team.
"This may reflect the increased legal pressures nurses are feeling today," Wagner said. "Many nurses have told us they'd personally want to allow patients the dignity of a natural death, but they feel legally obliged to initiate heroic measures."