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?

[russianbear]

The doctor didn't seem to have a problem with it.

[turnforthenurse, MSN, NP]

I have made countless suggestions to doctors. Most of the time I never had a problem with it unless I was working with a doc who didn't like to take suggestions from nurses.

[OyWithThePoodles, RN]

Our docs prefer us to make a suggestion, it conveys to them that we know our stuff, and what our patient may need. They will either agree or say something along the lines of "how about we try....". When a new nurse is hired they will ask him/her "What do you think would help the patient most?" To try and get their critical thinking gears cranking. You did the right think in my opinion, if the doc doesn't like your suggestion they will recommend another.

[AngelicDarkness]

Oh golly - I don't think there is a day when I don't advise a medication :) No worries OP. Most physicians find it very helpful - especially when they don't know the patient that day.

[Spidey's mom, ADN, 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.

Same here. Our hospice docs appreciate it.

The doctor didn't seem to have a problem with it.

I was going to ask you that. I don't think you did anything in wrong in asking about a medication.

[poppycat, ADN, BSN]

The doctor didn't seem to have a problem with it.

If the doctor was ok with it then your coworkers need to learn how to talk to them, too. The problem is with the other nurses, not with you or the doctors.

[nynursey_]

The "R" portion of SBAR stands for "recommendation" (or at least it continues to stand for that in my facility) and that often involves suggesting or "recommending" a medication, a diagnostic test, or a treatment. You weren't overstepping your boundaries; you were being a good advocate. Never let another nurse talk you out of what you feel is right, unless you're already questioning yourself, or you specifically ask for an opinion. Stand your ground.

[f1j1nurse]

Well your nurses would rip me new one everyday. I make suggestions to my doctors everyday and it is well received where I work. I even have an MD who usually calls me and asks me for suggestions...lol, he's really old and has not kept up wit the latest STD treatments. Keep doing what you are doing, you will go a long way:)

[TheCommuter, BSN, RN]

Making recommendations to physicians is situation-dependent...

In the area where I live, many of the physicians are foreign-born males who come from cultures in which females are not expected to make suggestions to men. Therefore, I word my suggestions differently when dealing with these doctors.

I'll give them the situation, background and assessment. I'll throw in my recommendation and immediately end it with, "So how do you wish to proceed, Doctor?" Even though I've recommended something, this ending keeps the ball in the doc's court.

[bebbercorn]

Come work in ED. It's common practice. But like the wise Commuter states, there's a way to phrase it with certain docs... "I was thinking maybe Benadryl, or something similar..." for the ones with ego, and for the down to earth ones "He's itching, time for benadryl?"

[Karou]

I don't work in a teaching hospital. I work at a large 700+ bed hospital on a med surg floor, which gets a large variety of hospitality and specialist doctors. We make suggestions all of the time!! Its not that uncommon for a doctor to ask a floor nurse for suggestions either. There is nothing wrong with asking if the doctor thinks Benadryl could be helpful. That's advocating for your patient. Which is our job.

[nrsang97, BSN, RN]

I make suggestions all the time. We can do that. Often times we are asked our opinion.