This Nurse I Work With

[TrudyRN]

She really does her own thing. She practically writes her own orders. The docs are not really aware of things she does because she never charts them but she tells about them in report and during count. She gets upset when other nurses follow the more conventional route of actually conacting docs when we want something or need to report problems, tells us we're uptight and sissies. Sometimes I think she's right but I still do it the conventional way. Part of me wants her to get caught and part of me says "Mind your own Business." She has never harmed anyone, to my knowledge.:madface::angryfire:nono::uhoh21:

[meownsmile, BSN, RN]

I think your approach is best. You cant assume what a doctor might want for a patient. However, there are some things that could be done IF you are very aware of your doctors practices. Its just not smart practice to not discuss something with the doctor and report certain symptoms and assume he would want you to go ahead and give Tylenol or something like that. About the time you did, he would want blood cultures or something else so err on the side of caution and call them. They take their own call for a reason and they knew going in that they would be getting calls in the middle of the night.

[traumaRUs, MSN, APRN]

This is why it is so important that we have standing orders or protocols set up...so as staff nurses, we are not practicing w/o a license!

This nurse could easily lose hers.

[Music in My Heart]

This nurse could easily lose her (license)

In most states, being licensed as a Professional Engineer carries with it the duty to report to the state board any actions by a fellow PE which are either unethical or violate the practice act.

Does not a nursing license come with the same mandate?

[leslie :-D]

trudy, i'm not sure what specifically you're referring to, in regards to what this nurse does.

but it sounds like she knows she should be contacting an md but takes it upon herself to handle it.

that's why she won't chart and keeps her actions known verbally.

this nurse is totally nuts.

and she's walking a very thin line.

leslie

[EmmaG, RN]

In most states, being licensed as a Professional Engineer carries with it the duty to report to the state board any actions by a fellow PE which are either unethical or violate the practice act.

Does not a nursing license come with the same mandate?

Yes, at least in the state where I currently practice.

[mak2]

If she is following existing protocols she is probably a great nurse. You dont really explain exactly what she is doing. If she is doing things that require a physican's order and she does not have one that has to be reported, not optional. I think nursing is OC about charting but some things really do need to be charted.

[RNperdiem, RN]

Compare the situation to driving without a seatbelt. Just because someone drives without a seatbelt and has never come to harm does not mean that what you are doing is wrong.

If this nurse should screw up, the hospital will hang her out to dry. There is nothing wrong with protecting your patients and yourself.

[Ms.RN]

she really does her own thing. she practically writes her own orders. the docs are not really aware of things she does because she never charts them but she tells about them in report and during count.

umm, what kind of orders is she writing on her own? i hope shes not giving any meds without md order. anyways, i work in nursing home and if a patient have a skin tear, nurses write an order to put antibiotic ointment and dry dressing. docs dont really mind nurses writing orders like that.

i have concern about nurses i'm working with too. when patient is nauseated, nurses give im injection of tigan without really calling the doc. cant patient have reaction to tigan or are there any contraindication to giving this medication to patient?

[CaLLaCoDe, BSN, RN]

one time a doctor told me to write the order for butt paste without ever having to call him when he was making rounds. i told him that i was glad that i didn't have to call him at 0300 to get the order with a tongue and cheek attitude. he says, "you call me at three a.m. and you'll get an order for tooth paste, not butt paste!" very funny md!

seriously though, mds are there to be called even at 0300. i'd rather have a happy pt rather than a grumpy doc. but in all honesty, i do call at 0600 if i can...i know some of the docs are considerate of me too in return ;-)

[blueheaven]

I worked on a tele unit and we had protocols for most stuff. After working there for a while and the doctors felt comfortable with me, I could go ahead and get labs before calling them. The key is I CALLED THEM and got the verbal order. Don't know what the nurse in question is doing, but sounds like she is skating on thin ice!

[blueheaven]

She really does her own thing. She practically writes her own orders. The docs are not really aware of things she does because she never charts them but she tells about them in report and during count. She gets upset when other nurses follow the more conventional route of actually conacting docs when we want something or need to report problems, tells us we're uptight and sissies. Sometimes I think she's right but I still do it the conventional way. Part of me wants her to get caught and part of me says "Mind your own Business." She has never harmed anyone, to my knowledge.:madface::angryfire:nono::uhoh21:

Could you go up the chain of command? Document what she is doing in a non accusatory manner and go to your NM or supervisor. Keep a copy for yourself in case things get lost. There is a reason we don't have MD after our name!