autonomy - page 2

Hello! I'm from Canada, where I've been nursing for 13 years. Included in my experience is teaching nursing students, in med/surg. I also have been working the past 7 years in NICU. I decided to... Read More

  1. by   TheLionessRN
    Oh wow, you mean you can't do something simple like put on a sat monitor??? Is it possible that you are being told not to by a nurse who has no independent thought on her part? Or a territorial thing with RT....This is really interesting.
  2. by   kmaryniak
    Okay, I'm glad I'm not insane for thinking that it is stupid. But it is. I had a kid (I work NICU), who was starting that lovely "stridor", so I went a put a sat monitor on him. Then I was told (by more than one person), that I'm not supposed to do that without an order. I actually had to track down the doc to get a "cover" order. Also, even though I've worked with neonates for 8 years, I'm not allowed to use judgement when to dress them, try to bottle them, or put O2 on them without orders!
  3. by   Rohb
    Unbelievable,what are you up there ROBOTS..I've been working as anurse for 7 years now and in the last 3years Iam in Rehab ward.Somethimes I think I got too much autonomy,I work mostly PM Shift ,where doctors go home @5:30 and all we have are on-calls DR's.
  4. by   Tweety
    Technically speaking we need an order for just about everything we do. We can administer up to 2L NC without an order, we can do accuchecks whenver we want to.


    However when a patient is in need, for instance if they need an EKG or an ABG, or CBC, I'll do all of that, get my ducks in a row and call the doc. Why call the doc and say "he's having chest pain" only to have her/him surely say "get an EKG". I'll say "I did an EKG for chest pain and it shows......" Then after talking with her, I'll write the orders.

    Or if someone has an accucheck of 20, while someone is calling the MD, I'm giving an amp of D50W.
  5. by   SmilingBluEyes
    Originally posted by kimmy2
    . Does the term "nursing judgement" ring a bell with anyone else?
    Actually it **does** ring a bell for me; but autonomy in nursing is BROAD by definition, even from one hospital to another in the SAME STATE! (I know from personal experience just working at two different places as a labor/delivery nurse). No need to get this snippy! sorry I asked. Maybe, this hospital is NOT the place for you to work?
  6. by   SmilingBluEyes
    Originally posted by 3rdShiftGuy
    Technically speaking we need an order for just about everything we do. We can administer up to 2L NC without an order, we can do accuchecks whenver we want to.


    However when a patient is in need, for instance if they need an EKG or an ABG, or CBC, I'll do all of that, get my ducks in a row and call the doc. Why call the doc and say "he's having chest pain" only to have her/him surely say "get an EKG". I'll say "I did an EKG for chest pain and it shows......" Then after talking with her, I'll write the orders.

    Or if someone has an accucheck of 20, while someone is calling the MD, I'm giving an amp of D50W.
    Yep this post makes sense to me.
  7. by   traumaRUs
    I think we can all agree that autonomy is in the eyes of the beholder. While I feel that standard protocols give ER nurses quite a bit of leeway - it still stands to reason that legally, we have orders to do so. I think a lot of posters have a valid point.
  8. by   kmaryniak
    SmilingBluEyes- I did not mean to sound "snippy", nor insulting. I just meant that a lot of issues I have surround nursing judgement, which I feel that, on my unit we are not allowed to have. I think you misinterpreted my post, or my tone. Sorry!
  9. by   SmilingBluEyes
    Originally posted by kimmy2
    SmilingBluEyes- I did not mean to sound "snippy", nor insulting. I just meant that a lot of issues I have surround nursing judgement, which I feel that, on my unit we are not allowed to have. I think you misinterpreted my post, or my tone. Sorry!
    Well my name sure does not fit me today...I am sooo bytchy. I am sorry, I guess I just read that all wrong. Chalk it up to PMS and oversensitivity. I am sorry!!!
  10. by   kmaryniak
    "It's all good".

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