(dissenting).
I would affirm the Commissioner. Four actions of Ress are cited as inappropriate:
(1) Lavage of the endotracheal tube with iced non-sterile saline solution;
(2) Refusing to adjust the endotracheal tube as suggested by the resident;
(3) Suggesting, ordering, and administering epinephrine instead of determining whether vasopressin was available, as the resident had suggested; and
(4) Refusing the resident’s order to immediately obtain a chest x-ray.
The first three actions were taken during an emergency. While they may have been inappropriate and negligent, I agree with the majority that in acting under emergency conditions Ress may have believed that he was saving the life of the patient. Thus, while Ress’s emergency actions may have been sufficient to warrant his discharge from employment, as a matter of law they did not constitute misconduct so as to deprive him of his right to receive unemployment compensation. See St. Williams Nursing Home v. Koep, 369 N.W.2d 33, 34 (Minn.Ct.App.1985) (citing Windsperger v. Broadway Liquor Outlet, 346 N.W.2d 142, 143 (Minn.1984)); Auger v. Gillette Co., 308 N.W.2d 255, 257 (Minn.1981).
I am troubled, however, by Ress’s refusal to comply with the resident’s direct order to obtain an x-ray to pinpoint the source of hemorrhage. The Commissioner’s categorization of that action as misconduct was, I believe, correct. At the time of the resident’s order to obtain an x-ray, the immediate emergency had passed. The patient was resting quietly. In acting as he did, Ress engaged in insubordinate conduct similar to that which was determined to be disqualifying in Woodward v. Interstate Office Systems, 379 N.W.2d 177 (Minn.Ct.App.1985) and Daniels v. Gnan Trucking, 352 N.W.2d 815 (Minn.Ct.App.1984). If in fact Ress as an experienced registered nurse believed that the order of a first year resident medical doctor would unduly disturb the patient who was now at rest, Ress had alternatives other than insubordination available to him; as observed by the Commissioner, Ress could have contacted a superior physician.
Finally, I share the concern expressed by the Commissioner that the conduct of Ress was “particularly egregious in the light of this employer’s business.” Employee misconduct in a hospital setting may result in consequences which extend far beyond those which can be measured in economic terms.