Nurse Advocacy in Military Clinics: A Critical Role in Patient Safety

Military nurses often find themselves in complex and challenging environments where the balance between following direct orders and advocating for the well-being of their patients is crucial. While some may argue that strict adherence to orders takes precedence, I firmly believe that a nurse's duty to advocate for a patient's safety supercedes any other directive.

Examples of Situations Where Patient Advocacy Comes First

During my service as an Army medic, I encountered several instances where the duty to the patient overrode the need to follow orders. These examples highlight the importance of prioritizing patient safety, even when it conflicts with military protocol.

Ordering a Dangerous Overdose

One scenario involves a medical officer (MO) giving a patient a potentially harmful overdose. If this is due to a miscalculation and not an outright intention to harm, the order is technically not illegal. However, by not following this order, a nurse protects the patient from unnecessary risk and the MO from facing the repercussions of incompetence. This action aligns with the broader responsibility of ensuring patient safety.

Medical Fitness for Duty

Field medics frequently work with non-medical officers. In cases where an officer asks a medic to declare a soldier fit for a specific task, the medic has both a professional and a military duty to adhere to their training and medical judgment. Even if the order is from an officer, the medic's responsibility to the patient's well-being must take precedence. Declaring an unfit soldier fit based on orders alone could lead to serious health risks for the individual.

The Patten Incident

A particularly notorious example is the Patten incident, where the commander, Patten, struck a soldier who was under treatment for battle fatigue. Though the medical staff present did not challenge Patten due to his standing, the principle that soldiers cannot be harmfully disciplined by non-medical personnel stands. Military law strictly prohibits the physical abuse of soldiers, and any such actions must be reported and addressed immediately. A nurse in such a situation would have a moral and professional duty to prevent the abuse and ensure that the perpetrator faces the appropriate legal consequences.

The Defense of Disobeying Orders

According to my training and personal belief, protecting a patient from harmful or negligent actions constitutes a complete defense against charges of disobeying orders. When a nurse identifies a situation where a patient's safety is jeopardized, the duty to act is paramount. Such actions not only protect the patient but also uphold the integrity of the medical profession and the rule of law in military settings.

Conclusion

In the complex environment of a military clinic, the role of the nurse as a patient advocate is critical. By prioritizing patient safety, nurses can ensure that medical practices and protocols adhere to the highest standards, reflecting the best interests of the patients they serve.