I'm a new nurse... although have spent my past 30 yrs. around the nursing profession and in the medical field.. have seen a lot, done a lot...now I need some clarification. Perhaps this comes as a result of having served in the military where the docs carried the rank, and therefore we all submitted to their say... but somehow, I still carry around this "outdated" concept of feeling that I must "obey" the docs.
It was a real eyeopener in school to learn about nursing autonomy and the nursing profession's view on this. But somehow, this past concept still lingers and I need some help in shaking it. I still find myself being intimidated by the docs (or at least FEELING like I SHOULD be) and like who am I to question them in ANY regard, or on ANY subject when it comes to patient care. I still allow them to make me feel like it's THEIR patient more than MY patient, and I struggle with knowing where I stand, where the line is, when do I question them, when do I make judgement calls on my own, do I have the right, and WHEN to do so, etc., etc.
Guess it's the old-school thing where the doc makes the decisions and the nurses implement his "orders" without question.
WHEN is it appropriate do do otherwise, how do I know, how do I stand up to it when it DOES occur.. are they "my boss" or not, can "they" have you fired.. etc. etc......... really need some help on this, some real clarification. I want to be a competent and responsible nurse, but I need further guidelines in working out
this issue to enable me to perform to my best abilities and know what I MAY and/or may NOT do concerning the docs. Thanx everyone, in advance.
Oct 13, '02
Imagine for one minute that patient is YOUR sister/brother, mom/dad, grannie/gramps or FRIEND. Would you feel absolutely good about what you are doing for him/her? IF not, time to examine WHY and take ACTION. This takes courage and conviction and willingness to risk the wrath of some, but how can you do less?
I remember, I was a 1st year graduate nurse and a doctor was making all manner of unreasonable and DANGEROUS decisions on the floor. It was night shift and the House Supervisor and other doctor on the floor saw all that was going on but failed to back me up when I needed the help. Welp, Being charge nurse (yep in my 1st year in a rural hospital), I took exception and challenged him (in a professional manner) about it. HE told me he would have my job when I refused an order that I considered dangerous. I replied if he got away w/all this, HE COULD HAVE MY job cause NO way was I working under such needlessly dangerous conditions, which were all unwarranted.
Then, being the type to CYA, I wrote up a long memo about each event, including times, specifics and patient names involved. I also met w/my nurse manager for a breakfast conference about what occured after my shift was over at 7:30. By the time I was thru talking w/her, I was in tears. That I managed to keep my cool on the floor was a fortunate thing.
Anyhow, that memo (thank Heaven I wrote it), was asked for at an OB committee meeting....guess what; the Chief of Staff stood behind NURSING, based on the details presented there. Now of course, I was not at that meeting, but the fact that I stood my ground (trembling, oh yes) made me feel good and made me stronger in my convictions to do the right thing.
It is remembering *why* we are there and WHO we PLEDGE to advocate for, that keeps me on the right road most of the time. Sure, I mistakes. Sure, sometimes I have great trepidation about upsetting physicians and patients. I did not say it is easy to do, but when you look at it this way, a lot comes into focus that matters, and it makes decision-making a bit clearer. Good luck, hang in there and keep your convictions!:kiss
Last edit by SmilingBluEyes on Oct 13, '02