I've been beating myself up over this for days and I just want to get someone else's perspective. I apologize in advance for the wordiness
I work in a chronic, non acute setting where the patient's come in for treatment 3x/week, the patient's don't see a doctor or NP everyday but at least 1x/week.
I was assigned a notoriously difficult patient this week. Threatens to sue on a weekly basis, doesn't trust anyone's RN judgement, has "allergic" reactions to almost everything, and is generally a crab apple.
She has a standing order for a large dose of benadryl IVP 75mg per treatment. She complains of the medical tape itching her and our general patient population get's very dry and rough itchy skin as a manifestation of their illness.
During treatment she started crying and wailing and begging for more benadryl. I told her I can't give her anymore, because I only have an order for 75mg. Which is already a high dose. I called the on call physician because the patient was in hysterics to see if they would authorize any more. In retrospect I think the patient was just putting on a show in an attempt to get more drugs.
The physician wasn't rude or condescending but he basically said he would NEVER give any more then 75mg for something as non life threatening as itching. He was surprised that I would even call to ask.
Now i'm a new nurse about a year, I didn't expect him to authorize more but legally I thought I had to call to at least ask the doctor. I'm a nurse, I can't decide what's enough medication for a patient, don't I need a MD or NP to actually say no before I tell the patient no. I called the doctor because if the patient actually does decide to follow up on her weekly threats to sue the clinic, I thought it would be better to have it documented that the patient had a complaint, I performed an intervention by calling the doctor, and the doctor said no. If I hadn't called the doctor and she sued, the doctor could have said well nobody told me the patient was experiencing pain.
Was I wrong to call the doctor? I'm second guessing my decision. I try at all times to cover my bases with as much documentation as possible but now does the doctor think I'm an idiot?
