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No DNR on file. Just the MPOA. Pt's code status was DNR with care and comfort.
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I am sorry you have been punished in this manner. The physician was acting in direct violation of the MPOA and was exposing the hospital to liablity. It may have been a better course of action to have approached your supervisor before addressing the MPOA, but I do not see a HIPAA violation since the MPOA holder stands in the place of the patient and thus it is not a violation of the patient's privacy.
Unless the hospital has a policy, I do not know if a nursing violation or skills violation in what you did. If the hospital has a policy as such, then you should be able to be shown the policy.
I would consider addressing this with the Supervisor of Nursing. It sounds like the doctor is heaving his weight around because you 'disrespected' him. If you explain as you did here, that you were making a clinical determination of the current status of the DNR via the MPOA, then your actions should have been with proper medical protocol and your termination is retaliatory. If this is the case, then you may have a cause of action as a whistle blower. I would think that the doctor issuing orders for the treatment could be construed as a attempt to run up the bill with the insurer or Medicare... If so there could be issues for him and the hospital if they are not careful. Medicare fraud is very serious.
If you feel that this may be the case, you will want to consult with an attorney near you who has experience in Whistle blower act and the possibly of a Quai Tam Act for Medicaid Fraud.
I wish you the best.
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