Can you recommend a medication?

[russianbear]

I'm new, please do not flame me. The other night my patient was complaining of burning sensation around th mouth? Itching eyes, tingling. Her face was slightly more puffy than when she was admitted several hours before. I called the physician and told him and asked if Benadryl would perhaps be helpful. He said he would be in in a few hours and address it. Afterwards the other nurses ripped me a new orifice saying you never suggest anything to doctors, we do not diagnose, etc. I wasn't practicing medicine, I was merely asking if that would be helpful. Thoughts?

[poppycat, ADN, BSN]

Maybe the other nurses are afraid of the doctors. I've made lots of suggestions to lots of different doctors in my career & no one has ever told me I shouldn't do that. That isn't practicing medicine; it's advocating to get what your patient needs. It would only be practicing medicine if you actually gave the Benadryl without having an order.

[russianbear]

They do talk often about Doctors scolding them here if you question them, etc. I cannot imagine I would allow myself to be spoken to the way they describe. I would probably speak my mind and lose my job if it happens as I don't tolerate being mistreated very well.

[poppycat, ADN, BSN]

Exactly. People will treat you whatever way you allow them to.

[mmc51264, BSN, MSN, RN]

OMG we do it all the time! I work on an ortho floor at a teaching facility. Sometimes residents need a little help. It's all in how you word it. "Do think X might help?" or "Sometimes we use X for this, what do you think?" Sometimes it is just a matter of them not ordering something that might be part of an order set. We give a lot of narcotics, so we have issues with constipation, sometimes we need to remind them about a bowel regimen med. Or tylenol. That's my biggest pet peeve. It is very underrated.

[tsm007]

Um the people you work with obviously haven't been taught SBAR - Situation, Background, Assessment and Recommendation (SBAR) technique. I'd get them some reference material on that. Here's a link for you SBAR. The R part of SBAR is RECOMMENDATION. This is what they are teaching in school that nurses should make recommendations. I think you coworkers are completely wrong. I think you made the right call asking for benadryl.

[loriangel14, RN]

OMG we do this all the time. Quite often we just tell them what we want or they will ask what we want an order for.

[russianbear]

That is exactly how I was taught. Also, this is not a teaching hospital. Just one with a lot of old god complex having physicians.

[Jensmom7, BSN, RN]

We make recommendations to physicians all the time in Hospice.

Matter of fact, I know a few doctors who will simply say, "Do whatever you want."

At that point I have to remind them that I don't have the letters after my name that would allow me to write orders without discussing it with them first.

[klone, MSN, RN]

That is exactly how I was taught. Also, this is not a teaching hospital. Just one with a lot of old god complex having physicians.

There is such a huge difference in culture and environment between teaching and non-teaching hospitals!

Keep doing what you're doing; maybe the other nurses can learn from you!

[klone, MSN, RN]

Matter of fact, I know a few doctors who will simply say, "Do whatever you want."

I have one provider who doesn't go to that point, but when I give her a report of my assessment, she always says "Okay, what do you think we should do?" Most of the time I appreciate that she values my judgment enough to put the ball in my court, but sometimes I just want to say "I don't know! I don't want to have to think, just tell me what you want me to do!"

[emtb2rn, BSN, RN, EMT-B]

Make suggestions all the time. To er docs, consults, an attending. Never had a problem. Docs seem to like the "here's the problem & my recommended solution" approach. Non teaching hospital.