Another great article by Theresa Brown RN
Healing the Hospital Hierarchy
March 16, 2013
...Most people in health care understand and accept the need for clinical hierarchies. The problem is that we aren't usually prepared for them; nor are we given protocols for resolving the inevitable tensions that arise over appropriate care. Doctors and nurses are trained differently, and our sense of priorities can conflict. When that happens, the lack of an established, neutral way of resolving such clashes works to everyone's detriment.
This isn't about hurt feelings or bruised egos. Modern health care is complex, highly technical and dangerous, and the lack of flexible, dynamic protocols to facilitate communication along the medical hierarchy can be deadly. Indeed, preventable medical errors kill 100,000 patients a year, or a million people a decade, wrote Rosemary Gibson and Janardan Prasad Singh in their book "Wall of Silence."
Nurses cannot give orders, but they are considered the "final check" on all care decisions that doctors make, and we catch mistakes all the time. The most striking example from my experience: chemotherapy intended to be given intravenously was ordered with the formula for delivery to the brain. Depending on the drug, this could have been a thousandfold dosing error....