Am I wrong? Is this legal?

[bossfrog]

I have been a psych nurse for 6 years and did some traveling for a while. At my current job in Indiana (which is a permanent job, not travel), they have a practice that I'm not comfortable with and I can't seem to find anything definitive to confirm what I believe to be true even though I'm fairly certain I'm right. What they do here is on night shift, when a referral comes through, they expect the nurses to make the decision whether or not to admit a patient. If the criteria is clear (such as psychosis or suicide attempts) then they want us to get consents and give the referring agency the go-ahead to send the patient without calling the doc. None of the 5 psychiatric facilities prior to this one ever did this. Even when the criteria was clear, they ALWAYS called the doc for the decision to admit. Now the understanding here is that if it's a clear case, the doc will sign off on the admit orders. But the question I have is what if a patient gets admitted that the doc says he wouldn't have accepted? You can guess who would get the blame.

I have refused to do this, with the support of some peers and the scorn of others. RNs do NOT have admitting privileges to my knowledge and there can be no such thing as a standing order to admit non-specified patients. One of the unit secretaries actually wrote me up for refusing to make a unilateral decision on a patient! Am I way off base here? Is this common practice and this is simply the first time I've run across it? Most importantly, is it even legal? Should I report the write-up to the Nursing Board? Hell, should I report the hospital itself and start looking for a different place to work?

[Crush]

I have never hesitated or had issue with calling a doctor at any time, day or night. If I need them, then they are getting a call. They know they are on call and that that is a part of their job. So glad the MD's where I work have never once given me attitude when I have called or when they call to let me know there is an admit coming and give me a short report along with letting me know orders are already in the system. Including the psych ward.