Byrd v. Marion General Hospital

Bbogden, J. What duty does a nurse owe to a patient? At the outset it must be observed that no judgment was sought against the hospital or the physician of plaintiff who directed that she be sent to the hospital and given the specific treatment, which is the basis of plaintiff’s cause of action. The great majority of cases discussed in the books involve the liability of hospitals for the negligence and inattention of nurses. The liability rests upon the theory that the nurses in discharge of their duties are agents or servants of the hospital. In this case, however, the liability is asserted against the nurse personally, and against her husband who was the lessee of the hospital upon the principle of respondeat superior. The general rule of legal liability imposed upon hospitals, nurses and physicians undertaking to treat patients are succinctly, expressed by Stacy, G. J., in Pangle v. Appalachian. Hall, 190 N. C., 833, 131 S. E., 42, as follows: “Ordinarily, when a hospital, like the present one, undertakes to treat a patient, without any special arrangement or agreement, its engagement implies three things: (1) that its physicians, nurses and attendants possess the requisite degree of learning, skill and ability necessary to the practice of their profession, and which others similarly situated ordinarily possess; (2) that its physicians, nurses and attendants will exercise reasonable and ordinary care and diligence in the use of their skill and in the application of their knowledge to the patient’s case; and (3) that its physicians, nurses and attendants will exert their best judgment in the treatment and care of the case.” See, also, Johnson v. City Hospital, 196 N. C., 610, 146 S. E., 573; Bowditch v. French Broad Hospital, 201 N. C., 168; Schloendorff v. Society of N. Y. Hospital, 21 S. W. (2d), 125; Norwood Hospital v. Brown, 122 Southern, 411, 22 A. L. R., 341; 39 A. L. R., 1431. These cases and others of like tenor support and fortify the measure of liability expressed in the Tangle case, supra. The great weight of authority, however, establishes the principle that nurses, in the discharge of their duties, must obey and diligently execute the orders of the physician or surgeon in charge of the patient, unless, of course, such order was so obviously negligent as to lead any reasonable person to anticipate that substantial injury would result to the patient from the execution of such order or performance of such direction. Certainly, if a physician or surgeon should order a nurse to stick fire to a patient, no nurse would be protected from liability for damages for undertaking to carry out the orders of the physician. The *342 law. contemplates that tbe physician is solely responsible for tbe diagnosis and treatment of bis patient. Nurses are not supposed to be experts in tbe technique of diagnosis or tbe mechanics of treatment. Tbe evidence in this case discloses without contradiction tbe following vital and pertinent facts: (a) That Dr. Bingham was tbe physician of plaintiff, who directed that tbe plaintiff be placed in tbe custody of defendants or taken to tbe hospital. (b) That be examined tbe plaintiff and diagnosed her disease. (c) That be specifically prescribed tbe immediate treatment in tbe sweat cabinet owned and operated by tbe Millers. (d) That be was present at tbe time tbe treatment was administered. While there is a conflict in tbe evidence as to whether be was present when tbe plaintiff was prepared for tbe cabinet or when tbe treatment was actually commenced, there can be no controversy that be was present within ten or fifteen minutes from tbe time she was placed in tbe sweating machine. (e) That tbe physician, within a few minutes from tbe time tbe plaintiff was placed in tbe cabinet, was thoroughly advised as to bow she was prepared .for tbe treatment and tbe general methods and progress thereof. Indeed, it appeared, without contradiction, that be prescribed a hypodermic during tbe course of tbe treatment. (f) That tbe physician, being present at tbe time, directed tbe nurse specifically to keep tbe plaintiff in tbe-cabinet for a period of thirty minutes. (g) That tbe appliance was approved and in general use, and there is no evidence of any defect in tbe instrumentality or of excessive beat. (b) There is no evidence whatever that tbe defendant, Mrs. Miller, was incompetent or that she did not possess that degree of skill which tbe law requires, or that, in operating tbe machine, she failed to exercise tbe degree of care which tbe law deems essential. From tbe foregoing facts it must be manifest to any impartial mind that tbe serious and distressing injuries of tbe plaintiff resulted from one or all of tbe following factors: (a) her body was improperly wrapped before being exposed to tbe beat; (b) that she was suffering from some disease rendering her unusually sensitive to beat application; (c) that she was retained in tbe cabinet for too great a period of time. If tbe injury resulted from a peculiar condition of plaintiff’s body, producing unusual or abnormal susceptibility to beat, then this was a matter of diagnosis and lay exclusively within tbe duty of tbe physician, unless, of course, as hereinbefore indicated, tbe type of disease was so *343 pronounced and so well known as to lead tbe nurse in the exercise of ordinary care to anticipate injury. However, upon that aspect, there is no evidence. If the injury resulted from subjecting the patient to the heat of the cabinet for an excessive period of time, then the evidence disclosed that such period of time was actually prescribed by the physician who was present during the treatment. The only aspect, therefore, upon which the liability of the nurse or of her husband, upon the principle of respondeat superior, can be based, is that the patient was improperly wrapped or covered before the treatment was administered. Obviously, if a patient is carried to a hospital by the order of a physician ánd the nurse undertakes to administer a treatment without instruction from the physician, or when the physician was not present, she will be held liable in damages for any failure to exercise ordinary care, and consequently, would administer such treatment at her peril. But, upon the Other hand, if the physician is present and undertakes to give directions, or, for that matter, stands by, approving the treatment administered by the nurse, unless the treatment is obviously negligent or dangerous, as hereinbefore referred to, then in such event the nurse can then assume that the treatment is proper under the circumstances, and such treatment, when the physician is present, becomes the treatment of the physician and not that of the nurse. Upon the whole evidence the court is of the opinion that, even if it be conceded that the body of plaintiff was not properly prepared for the treatment when her physician stood by without protest or direction, and being fully cognizant of the condition of her body and of all the facts and circumstances surrounding the treatment, the preparation of the body was a part of the treatment prescribed by the physician. Moreover, there is an abundance of evidence, and none to the contrary, that the heat was usually applied to a nude body, resulting in no harmful consequences. So that, there was nothing to indicate to the nurse that the preparation of the body of plaintiff with the acquiescence and implied approval of the physician was obviously dangerous or likely to produce harm. Of course, if Mrs. Miller was liable in damages, her husband would also be liable because he operated the hospital and employed his wife as superintendent of nurses. Hence if Mrs. Miller is not liable in damages, no recovery could be sustained against her husband. The court, in reaching a conclusion, has given full consideration. to the application of the -principle of res ipsa loquitur. .All the facts causing the injury are known and testified to by various witnesses at the *344 trial. Hence tbe doctrine is not applicable for tbe reasons pointed out in Springs v. Doll, 197 N. C., 240, 148 S. E., 251. Tbe court concludes upon all tbe evidence and upon tbe proper application of tbe pertinent rules of liability, tbat tbe motion for nonsuit, duly made, should have been granted. Reversed.