Dr. Ben:  You used the word rape to describe what the nurse did.  I agree
that this nurse's action is unethical.  Also, since Jay stated that the
doctor had ordered EBM only, it appears that the nurse also went against
doctors' orders.
I believe that the legal term for doing something to someone against their
consent is assault and battery (hope Liz Baldwin or one of our other legal
experts confirms or corrects this).
The practice of supplementation by nurses appears to be very entrenched.
It is done by day nurses as well as night nurses, although possibly it is
more common among some night nurses because they have more opportunity and
fewer people to observe them (e.g. vigilant fathers).  I believe that to
stop this practice, there are a number of steps to be taken:
hospitals have to institute Baby-Friendly policies; nurses should be
instructed about the risks of the practice; mothers and their
support persons (fathers, other relatives) need to be
informed of the risks of supplementation (there are still many mothers who
believe that there is no harm to this practice and either don't question
it or even ask for supplements); physicians have
to WRITE explicit orders in the chart, and nurses who supplement without
documenting a valid medical reason should be disciplined.  Of course, if
mothers truly roomed in with their babies, most of these problems would be
avoided. That's why I'm working so hard both in patient education and in
changing hospital procedures to get REAL rooming-in established.
Unfortunately, this part doesn't apply in the NICU.
Although there are still a lot of cases like this one, it seems to me that
these practices are on the decline.  We can all do our part to hasten
their disappearance.  Alicia Dermer, MD, IBCLC, frustrated but ever
optimistic in Central New Jersey.