Our jobs as nurses is to protect/help/serve the doctors.

  1. 12 As a nurse, it is my job to ensure that the admitting doctor and all of the consults accurately assess the patients, order the correct labs, order the correct meds, read the consults notes, and do not miss anything with the patient. It is my job to report to the consulting physicians so they can write orders without ever seeing the patients. It is my job to point out trending high BPs and to convince the doctor that the patient needs an increase in BP meds. It is my job to ensure that doctors never have to deal with family members or answer any questions. It is my job to protect the doctors, make sure they are doing their job, make sure their orders are correct. I am an RN - an advocate for doctors.
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  3. Visit  thesundowner profile page

    About thesundowner

    thesundowner has '2' year(s) of experience and specializes in 'Rehab, Neuro, geriatrics'. From 'Florida'; Joined Apr '12; Posts: 46; Likes: 142.

    26 Comments so far...

  4. Visit  Dixielee profile page
    4
    Quote from thesundowner
    As a nurse, it is my job to ensure that the admitting doctor and all of the consults accurately assess the patients, order the correct labs, order the correct meds, read the consults notes, and do not miss anything with the patient. It is my job to report to the consulting physicians so they can write orders without ever seeing the patients. It is my job to point out trending high BPs and to convince the doctor that the patient needs an increase in BP meds. It is my job to ensure that doctors never have to deal with family members or answer any questions. It is my job to protect the doctors, make sure they are doing their job, make sure their orders are correct. I am an RN - an advocate for doctors.
    I think you pretty much summed it up! Unfortunately, you are correct!! I was working with a PA the other night in a VERY busy Fast Track. We see 100 patients per day. He kept writing orders for the wrong things for the wrong patients, IV meds when he meant PO, knee immobilizers on people with lacerations of feet, discharge orders on people he hadn't seen, etc. I am trying to figure out what he really means because I actually triaged the patient.

    When I would point out an order in question and asked for clarification, he responded saying, "you know what he needs, just fix the order to make it fit". He was not the only provider fortunately, so I could focus on "fixing" his errors. I finally told him, "I can do my job or I can do yours, but I'm not doing both". It never got any better, but I have a feeling he won't be working with us very long.

    Nurses have to learn at a very young age that they are responsible for implementing a blatantly wrong order, so if it sounds wrong or you don't understand it, then INSIST they clarify and make sure you understand!

    I saw a t-shirt once that said, "Thank a nurse! They are the ones who keep doctors from killing you".
    Amber628, Tragically Hip, silverbat, and 1 other like this.
  5. Visit  GrnTea profile page
    9
    if you think about it, all those things are really protecting the patient from inept physicians. we're not protecting physicians by doing all those things. we're protecting patients. you are absolutely not obligated to implement a wrong order. the reverse is true-- you are mandated not to implemement a blatantly wrong order.

    don't believe it? read your nurse practice act or the ana scope and standards of nursing practice, which applies to all rns. they mandate you to protect the patient first, not the physician-- the days of doctor-is-the-captain-of-the-ship, follow-doctor's-orders are looooong gone.
    Last edit by GrnTea on Jul 10, '12
    myelin, Amber628, Patti_RN, and 6 others like this.
  6. Visit  SoldierNurse22 profile page
    6
    Though this is a pretty good explanation of what nursing has become and (I can only assume) meant to be tongue in cheek, I disagree with the fundamental assumption behind the philosophy that nursing still finds its helpless place under the dictatorship of a physician.

    I am a nurse. I have my own license. I have an education that allows me to make intelligent, informed decisions in the care of my patients. I round with physicians whenever I can so that nursing concerns are voiced in the medical picture of the patient. I protect/help/serve the patients. I work alongside and next to the physicians, not below or behind them. If by some chance my duties to the patient include preventing a physician from ordering/implementing/completing a treatment that would harm my patient and thereby protect/help/serve the physician in the process, so be it. But make no mistake; I act on behalf of the patient, not the physician.
  7. Visit  Dixielee profile page
    2
    Quote from grntea
    if you think about it, all those things are really protecting the patient from inept physicians. we're not protecting physicians by doing all those things. we're protecting patients. you are absolutely not obligated to implement a wrong order. the reverse is true-- you are mandated not to implemement a blatantly wrong order.

    .
    i could have worded my comment better. what i was trying to say was the nurse is responsible if she implements a blatantly wrong order. it is the nurses responsibility to make sure those orders make sense and will do no harm.

    you are absolutely correct that we are doing these things to protect the patient, not the physician. the original post while tongue in cheek contained a lot of truth.
  8. Visit  HouTx profile page
    2
    In Texas, since 1983 we have a legally defined 'nurse-patient' duty that cannot be superceded by the physician-patient duty or physician 'orders'. Captain of the ship sunk a long time ago.
    SoldierNurse22 and PMFB-RN like this.
  9. Visit  PMFB-RN profile page
    1
    not me. what i do i do for my patients. in my view the rns job is to heal the patient. the physicians job is to diagnose, and in the case of surgeons, do surgery. i heal them, or failing that assist them to the highest level of functioning possible for them, or failing that help them die as comfortably as possible. they are _my_ patients.
    SoldierNurse22 likes this.
  10. Visit  PMFB-RN profile page
    0
    Quote from grntea
    don't believe it? read your nurse practice act or the ana scope and standards of nursing practice, which applies to all rns. they mandate you to protect the patient first, not the physician-- the days of doctor-is-the-captain-of-the-ship, follow-doctor's-orders are looooong gone.
    *** great comment. as i can often be heard says "sure doc we can do whatever you want, as long as _i_ think it's a good idea". if not then either we arn't doing that, or you can explain to me, and convince me, why it's a good idea.
  11. Visit  Esme12 profile page
    2
    Quote from grntea
    if you think about it, all those things are really protecting the patient from inept physicians. we're not protecting physicians by doing all those things. we're protecting patients. you are absolutely not obligated to implement a wrong order. the reverse is true-- you are mandated not to implemement a blatantly wrong order.

    don't believe it? read your nurse practice act or the ana scope and standards of nursing practice, which applies to all rns. they mandate you to protect the patient first, not the physician-- the days of doctor-is-the-captain-of-the-ship, follow-doctor's-orders are looooong gone.
    grntea you beat me again... i couldn't have said it better!!!
    amoLucia and VivaLasViejas like this.
  12. Visit  amoLucia profile page
    1
    Hey Dixie - any chance that PA was impaired the other nite??? All those kinds of errors point to a practitioner with probems?

    I second the opinions of the other posters.
    Amber628 likes this.
  13. Visit  anotherone profile page
    0
    Our floor just hired a ton of new nurses and it is a big teaching hospital. The other night I was paging non stop and many drs called back to say , " what do you do in this situation?" , " is this what they typically do ?" Blind leading the blind and last month's intern is this weeks "upper level".
  14. Visit  Dixielee profile page
    1
    Quote from amoLucia
    Hey Dixie - any chance that PA was impaired the other nite??? All those kinds of errors point to a practitioner with probems?

    I second the opinions of the other posters.
    I do wonder if he was impaired (nothing obvious except of course his actions). He is fairly new and I have not been impressed with his judgement. He is sloppy and careless with the way he practices, and that is NOT acceptable. I went to one of the ED docs who is responsible for the PA's and explained what was happening. I am not the only one to point this out and we are documenting. I work in a very busy trauma center (120,000 pts/yr) so these kinds don't last long.

    As I stated earlier, I do not advocate that nurses are here to protect the doctors. The original poster was being facetious and I followed in that vein. I have NEVER been afraid to call a doc on orders that are dangerous or just erroneously written (Like Rx for Vicodin 1 GM IV written by a very tired doc).

    The nurses have a wonderful, trusting relationship with our ED providers and we have each other's back but we will not tolerate incompetence or poor practice.
    Tragically Hip likes this.
  15. Visit  studentdrtobe profile page
    2
    Quote from dixielee
    i saw a t-shirt once that said, "thank a nurse! they are the ones who keep doctors from killing you".
    Quote from grntea
    if you think about it, all those things are really protecting the patient from inept physicians. we're not protecting physicians by doing all those things. we're protecting patients. you are absolutely not obligated to implement a wrong order. the reverse is true-- you are mandated not to implemement a blatantly wrong order.
    this whole "we protect patient's from those stupid, mean doctors" mantra has probably been one of the most annoying things i've encountered in medical training so far.

    you'd be surprised how often we residents and attendings protect the patients from nursing errors. i don't think i've gone a single day in the hospital this past year w/o fixing/preventing a mistake made by a nurse and this was fairly common during my two years of rotations during med school also (i'm a pgy-2 now). the number of nursing mistakes at every single hospital i've rotated through so far has far exceeded those made by physicians. the difference is that we doctor's only discuss this stuff in the physician's lounge and don't go around wearing shirts telling the public that we protect them from other healthcare workers' mistakes.

    i feel like physicians are the only ones who get any training regarding working in a health-care team these days. everyone else seems to be competing against each other, which is absolutely ridiculous in a clinical setting.

    Quote from pmfb-rn
    not me. what i do i do for my patients. in my view the rns job is to heal the patient. the physicians job is to diagnose, and in the case of surgeons, do surgery. i heal them, or failing that assist them to the highest level of functioning possible for them, or failing that help them die as comfortably as possible. they are _my_ patients.


    yea, no. my job isn't to just diagnose or just do surgery and then leave the rest of the care to someone else. i "heal" patients just as much as you do. don't make judgments about my job when you don't have any experience with it and i won't make any about yours. it's that simple. also, considering that physicians (and independent practitioners) are ultimately responsible for signing off on all patient care, they're actually my patients.
    Szasz_is_Right and anotherone like this.


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