By CYNTHIA McCORMICK
HYANNIS — A per diem nurse at Cape Cod Hospital has lost her job after having a religious discussion with a dying patient, according to hospital officials.
A petition circulating in the hospital calls for the reinstatement of Julie Peterson of Sandwich and affirms the right of nurses to provide spiritual as well as physical comfort. But a Cape Cod Hospital spokesman said yesterday the patient’s family complained that the nurse overstepped her bounds and distressed the patient, who was receiving hospice care.
"Anything that would involve a staff member upsetting a patient or upsetting a patient’s family, we would take very seriously," said David Reilly, who works in public relations for Cape Cod Healthcare, the parent company of Cape Cod Hospital.
Reilly would not confirm Peterson is the nurse involved in the incident or specify what she said to the patient. He said the incident is a private personnel matter.
The petition, which Peterson wrote, states the patient’s family accused the nurse of saying the patient must repent.
The family complained that the nurse made statements including "look what you’re doing to your family" and "there’s only one way — you must go home and repent," according to a letter Peterson attached to the petition.
Nothing like that ever happened, Peterson wrote. Instead, Peterson said she and the patient engaged in a spiritual discussion about religious and family matters while the patient was being discharged to go home to die.
"In preparation for discharge the patient had gotten a dose of IV morphine," Peterson wrote. "The patient had been discussing her decision to die and talking about her guardian angel with the nurse. The nurse asked the patient if she could ask her a personal question and upon getting a clear confirmation, asked the patient her thoughts on the afterlife."
The repentance issue came up after the patient commented "Christianity is narrow," Peterson wrote, to which she said she replied, "Yes, it is. If God were to be what the Bible represents then the access to him would be through repentance. Many other religions aren’t so exclusive."
After the patient became upset the next day, Peterson said she explained to hospital officials the nature of the conversation and offered to write a letter of apology. She also admitted to occasionally offering a prayer at a patient’s request.
Within days of the March 24 incident, Peterson said she was forced to resign. The family filed a complaint with the hospital March 25.
The patient, whom hospital officials would not identify, has since died.
Peterson said she wrote the petition at the request of co-workers who were upset about her losing her position as a per diem nurse. The petition was meant for the eyes of Cape Cod Hospital’s administration, not the newspaper, she said.
"I valued my employer and my relationships at the hospital," Peterson said during a telephone interview yesterday.
Per diem nurses are not considered hospital staff and are not entitled to all the job protections that come from being a union member of the Massachusetts Nurses Association, said Marilyn Rouette, chief of the MNA chapter at Cape Cod Hospital.
Per diem nurses are hired on a daily, temp-like basis to fill a certain number of hours. The hospital currently employs 89 per diem nurses in addition to more than 400 regular staff nurses, Reilly said.
"They make themselves available for certain number of hours," Rouette said. "The hospital can either put you on or not."
There are no hard and fast rules about what kinds of spiritual comfort a nurse can offer a patient, she said, adding nurses often refer patients to the hospital’s chaplaincy program.
"It depends on the moment, who the patient is and what you can give," Rouette said.
Peterson’s petition, which a hospital employee provided to the Times yesterday, states that forbidding nurses to discuss religion or politics with a patient is contrary to the widely held belief that cultural, spiritual and interpersonal relationships have a bearing on the patient’s wellbeing.
A patient misunderstanding a discussion does not constitute abuse, Peterson wrote, "but rather the nature of the profession we deal with — illness, grief, denial, death and dying."
Reilly said the hospital has no problem with nurses praying with patients at their request. The key point is caregivers must follow a patient’s lead, he said.
"We try to accommodate our patients and make them comfortable whatever ways we can," he said.