RN rounding for Doctors?

Specialties MICU

Published

In the hospital I am currently working at, I have noticed that many of the general surgeons, neuro surgeons, and even the pulmonologist have experienced icu Rn's who round for them, write orders, and take first call for them. Is this a common practice in other hospitals? The Md comes behind the RN and signs off the orders they write as a VO.

Specializes in critical care, trauma, neurosurgery..
But isn't that what the primary care RN for the patient is supposed to do?

In my unit, the primary care nurse documents on our assessment flowsheets, and any documents as directed by our facility. We do not write progress notes in the chart. Several of the different specialties have their own forms or format in which they want to use for their progress notes. Only the MD or their rounding RN writes these progress notes. If the primary MD consults another MD, the consult is given to their RN, and the RN sees them first to gather pertinent info and needs for that patient, then the MD will see the pt unless it is a stat consult.

Specializes in PICU, NICU, L&D, Public Health, Hospice.
But isn't that what the primary care RN for the patient is supposed to do?

no...different role, different employer...

Interestingly I think I just came across a job posting for a position like this. Employed by the hospital but the unit was physician services. It didn't really specify the total job function. It was in Virginia .

Specializes in Emergency, ICU.

Sounds like a cheap way to get around hiring a NP, who would be the appropriate provider for this job. Of course, the docs would have to pay this person the salary they deserve.

Besides the debate of wether this is good or bad practice, I believe APNs (and PAs) should be fighting for some legislation to protect their jobs.

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Many of those rounding as RNs for doctors and NOT as an NP have standing orders they write to move things along faster for the doctor. It is similar to protocols in the ER. In the ER, I have protocols for medicating and other orders I can perform before the doctor even sees the patient. It just keeps things moving along smoother if say labs are already ordered, procedures are set up for, etc. And the doctor then has to cosign the orders placed under protocol. The rounding nurse also gathers information and makes sure everything the doctor needs is available. It's nothing out of my scope of practice. This seems to be what you were describing originally.

Specializes in ICU.

We don't have this, precisely, but a RN has the hospitalist pager. She can give orders per protocol and will contact the physician for things she can't address herself when a staff nurse pages the hospitalist for orders. Different nurses rotate through this role, usually critical care nurses from my unit. I have wondered about the legality/risk of this sort of position as well.

It's the same as triage in the ER. You use your nursing judgement to assign patients to the appropriate acuity (which changes how fast a doctor sees the patient) and can order things per protocol. There is nothing about it out of a nurse's scope of practice.

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