Quote from btoddrn
I am currently in school for nurse anesthesia. I have been several different places with clinicals and have certainly experienced a lot of variation in "this is the right way to do it." Something I was curious about is how should you handle things when there is a discrepancy between what you (the CRNA) and the anesthesiologist believe is the right way to do something. Especially when it is something you feel is poor practice or patient care. Do you do whatever it is because he/she is the attending and signs as the supervising attending to the case? Do you step back with risk of ruffling feathers and say if that is what you think should be done, then you do it, because it is you that is also signing the chart? Or do you put your foot down and say it really needs to be done this way? If anyone has any experiences and examples, I would really love to hear them. Thanks!
Well, there really isn't another information given. I know you have to be discreet, but it's a hard to make a judgment based on, well, no information.
Where's the standard of practice and the P&P on whatever it is? What does it say? Do you have supported literature that says otherwise? Will it be considered/adopted by the deparment? You are considered a student, so that definitely puts you at a major disadvantage.
Either way, you have to be careful in how you approach the situation. If it is something grossly unsafe, well, then you have to put your foot down. Go on the side of safety. I have had similar disagreements with people in ICUs, even with some ologists backing me up. Some people make an issue out of things, and some people just consider it a learning experience and move on.
Follow the standard of practice, P&Ps, and that which is the safest thing to do. If safety will be sacrificed, you have to back up away from it, and then document why.
There are usually systems and channels for dealing with these kinds of things--but politics IS ALWAYS a factor--so just be careful. Is the issue definitely worth fighting over now? I mean will the patient absolutely be compromised? How big of a deal is the thing really?
Only you can answer this. Our information is just too limited. Darn, what is it the ologist wants you to do?