Quote from traumasurgRN
Just like meandragonbrett
said, they work in contact with the MD, not the hospital. More often than not, the nurse is usually rounding with the MD, or just a matter of a few hours before. I understand that this is usually the job of the APN.
I was under the impression that these were RN's that worked for the hospital, and not the MD. If they are the MD's office RN's there is in some states a leeway as far as others who perform duties that the MD directs--under the MD's license and malpractice. However, I thought this was the office medical assistant (unlicensed) debate--as an RN one has to work to the standard of their own license. And if they are in constant contact with the MD, then they are perhaps receiving telephone orders and not making up their own orders that then the MD signs off (or not) as verbals later. There's a huge difference between a nurse rounding, assessing and doing notes, suggesting and obtaining telephone orders and a nurse who is rounding, assessing, deciding what the patient needs next and writing their own orders for same, THEN informing the MD what they wrote so the MD can then sign off. Only a NP can do that. Otherwise, the RN is being a practioner, and the MD has no obligation what so ever to sign the orders that he did not direct. Which then begs the question--do you, as the care nurse in the hospital, carry out the order that the RN writes if the RN is NOT in contact with the MD? Again, utilization review would be all over this--as RN's that come into the hospital from the MD office round and write orders. (and I know you claim they are in constant contact with the MD--well, as the Rn who is caring for the patient, can you get your own orders from the MD?) You carry out said order. The MD then says "I never said that, I will not sign off on it...." then YOU are in hot water as well. Then the administration wants to know why it is that you are following verbals when the MD is not on the floor--from another RN who makes em up. Not to mention I am SURE that nudge, nudge, wink, wink, administration has NO CLUE that this is happening when the poop hits the fan......