JUST NEED HELP IN UNDERSTANDING

Imagine that you are a nurse in a large hospital. You have heard that there is new doctor in the psychiatry department but you have not met him. One day, you receive a call from Dr. Smith (the new doctor) telling you that he wants you to give Ms. Ruben, a patient, a dose of Astroten before he comes to examine her. He asks if you have it in stock and waits for your answer. You check the medicine shelf and find that you do have it and it clearly shows that the maximum dose should be 10 milligrams. He then orders you to give her 20 milligrams. Would you comply?
This was an actual field experiment under real world circumstances by Hofling, et al. (1966). Would it surprise you to know that 95% of the nurses who were called complied with the doctors’ order? This was true even though the dosage was clearly excessive and it was against hospital rules to take medication orders over the telephone.
Using what you have learned in this unit, can you explain the behavior of the nurses in this situation? Why did they obey the doctor even though they were breaking the rules and putting the patient at risk? Be sure to support your answer with information from the textbook or other appropriate psychology-specific sources. What implication does this have for hospital practices given the estimated 7700 deaths per year in the U.S. caused by medication errors in hospitals?

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The behavior of the nurses in this situation can be explained by the concept of obedience to authority, which is a psychological phenomenon that explains why individuals comply with commands or orders from those in positions of power or authority, even if they go against their own moral beliefs or common sense.

In this specific scenario, the nurses were faced with a request from a new doctor, Dr. Smith, who held a position of authority within the hospital. According to the research conducted by Hofling et al. (1966), which replicated the experiment in real-world circumstances, it was found that 95% of the nurses complied with the doctor's order, despite it being against hospital rules and involving a clearly excessive dosage.

One possible explanation for this behavior is the perception of legitimacy and expertise associated with the doctor's role. Nurses are trained to follow orders from doctors, as they are considered to have the necessary knowledge and expertise to make informed decisions about patient care. Therefore, the nurses may have felt obligated to comply with the doctor's request due to their perception of his authority and expertise, even if it meant breaking the rules or potentially putting the patient at risk.

Additionally, the experiment conducted by Hofling et al. (1966) also revealed the impact of situational factors on obedience. The nurses were put in a high-pressure situation, with limited time to consult with others or question the doctor's order. This sense of urgency and time constraints may have influenced their decision-making process, causing them to prioritize immediate compliance over safety concerns or rule adherence.

Furthermore, the socialization process within the healthcare system, where obedience to authority is highly emphasized, can also contribute to the nurses' behavior. Nurses are often taught to prioritize the chain of command and to follow orders without questioning them. This hierarchical structure can create a norm of obedience, where deviating from doctor's orders is seen as insubordination or a challenge to the authority figures.

The implications of this behavior for hospital practices are significant. The estimated 7700 deaths per year in the U.S. caused by medication errors highlight the importance of addressing the issue of blind obedience within healthcare settings. Hospitals should prioritize creating a culture of open communication, where nurses feel empowered to question orders and voice concerns regarding patient safety. Implementing protocols for verifying and double-checking medication orders, regardless of the prescriber's authority, can also help prevent medication errors.

In conclusion, the behavior of the nurses in this situation can be understood through the concept of obedience to authority. Their compliance with the doctor's order, despite it being against the rules and potentially harmful to the patient, is influenced by various factors such as perceived expertise, situational pressures, and the hierarchical structure of the healthcare system. Recognition of these factors is essential for promoting a culture of patient safety and reducing medication errors in hospitals.