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All the nurses in obstetrics and all the physicians on the obstetrics and gynecological service know that Dr. Borracho is an alcoholic. He frequently appears so intoxicated as to be unable to measure the dilation of the cervix.
On one occasion, he examined a woman and told her she had several hours before delivery. The baby's head appeared before he got out of the room. Until now, there have been no serious injuries to mothers or children, because the nurses have been able to stop him from committing really serious mistakes.
Of late, however, Dr. Borracho is getting violent when the nurses intercede. The director of nursing has been informed and has done nothing because Dr. Borracho has a lot of influence in the hospital and the director does not believe in rocking the boat with physicians.
Have the nurses done enough by reporting the problem? Should they go elsewhere in the hospital, such as to the physicians' peer review group? Should they use groups outside the hospital, such as the media, the State Department of Health, or the State Nurses Association? Should patients be encouraged by the nurses to file official complaints?
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