1. Obedience of Nurses to Doctors
The study by Hofling et al. (1966) :
This study on obedience (see Milgram 1963) examined how nurses complied with orders of medical doctors, even if they broke rules of the hospital.
In this study, a medical doctor who was on the staff list, but not known personally to a nurse, called her when she was alone in her ward in the evening; he says through the telephone:
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2. Obedience of Nurses to Doctors
„This is Dr. Smith, from Psychiatry, calling. I was asked to see Mr. Jones this morning, and I‘m going to have to see him again tonight – I don‘t have a lot of time, and I‘d like him to have had some medication by the time I get to the ward. Will you please check your medicine cabinet and see if you have some Astroten? That‘s [spells] ]A-S-T-R-O-T-E-N.“
The nurse looks in the medication cupboard and finds a pillbox with the following label from the hospital:
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3. Obedience of Nurses to Doctors
„This is Dr. Smith, from Psychiatry, calling. I was asked to see Mr. Jones this morning, and I‘m going to have to see him again tonight – I don‘t have a lot of time, and I‘d like him to have had some medication by the time I get to the ward. Will you please check your medicine cabinet and see if you have some Astroten? That‘s [spells] ]A-S-T-R-O-T-E-N.“
ASTROTEN
5 mg capsules Usual dose: 5 mg Maximum daily dose: 10 mg
The nurse looks in the medication cupboard and finds a pillbox with the following label from the hospital:
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4. Obedience of Nurses to Doctors
After the nurse returned to the phone, the doctor said:
„You have it? Fine. Now will you please give Mr. jones a stat dose of 20 mg – that‘s four capsules – of Astroten. I‘ll be up within ten minutes, and I‘ll sign the order then, but I‘d like the drug to have started taking effect.“
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5. Obedience of Nurses to Doctors
By giving Astroten, a nurse would violate several rules of the hospital:
The ordered dose was higher than the maximum daily dose;
Medication orders should not be given by phone
It was not permitted to give a medication that was not on the hospital stock list and cleared for use.
The order was given by an unfamiliar voice; the nurse had no chance to verify the true identity of Doctor Smith.
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6. Obedience of Nurses to Doctors
Astroten does not exist as a real medication, and the capsules were harmless placebos. The nurses were observed by a medical doctor, who interrupted them at the moment they wanted to give the medication.
What do you think: How many of the 22 nurses who were tested would have given Astroten?
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7. Obedience of Nurses to Doctors
Twenty-one of 22 nurses – or 95% – complied with the order of Doctor Smith and began with the administration of the medication, until the observing doctor interrupted them.
Other nurses were given a detailed description of the experimental situation and asekd whether they would have given the medication.
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8. Obedience of Nurses to Doctors
Ten of 12 respondents – or 95% – said that they they would not have given the medication, and seven said that they believed a majority would reject to give medication.
Of 21 student nurses, all said that they would not have given the medication.
This is in line with Milgram‘s (1974) finding that students could not predict other students‘ obedience in the so-called Milgram-study.
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