feeling like a taskmaster

[rnwaller]

I have been working ED for 9 years now. Lately, I am feeling like a taskmaster - I start the IV, give the meds, dip the urine, give the contrast etc ....

What I don't seem to have is any input/interaction with the diagnosis process. The best example of this is I walked out of a patients room the other day and the clerk says - OR is on the phone for report on Mr. 'A', I didn't even know Mr. 'A' was a positive appy (the doc never bothered to tell me.) In my opinion its a severe lack of respect for the nurse as a part of the team. I feel professionally stifled.

Anyone else experiencing this?

[ERRNTraveler, RN]

Some doctors are better about this than others- some will keep you in the loop, ask for your opinion on things, etc, and others won't tell you anything. I agree, the latter is irritating, but, it's just how some docs work. You could try talking to the doc about it, just tell them "I like to know as soon as possible when there's a change in the treatment plan for a patient, if you could keep me informed."

[Daytonite, BSN, RN]

Unfortunately, this was what I found my experiences as a staff nurse to be--technical nurse. However, when I went into supervision it was quite different. I found I was able to affect the practice of the other staff nurses as a mentor. Also, the doctors listen to the supervisors when you go a-calling them because they know you represent adminstration and that you are going to document and report any conversation you have with them. Power! It's even better if you are a manager.

[Zookeeper3]

sometimes with an 80 plus patient wait, chaos... these things with communication happen. I'm thinking that this i(lack of pt. discussion) is a common experience and not the above example. We're pretty close with our docs, a few harder to approach than others. I would feel comfortable talking to the doc and saying... "hey, you found a hot belly on scan, I'd have been better prepared to prep for OR if you shared that".

Now in their defence... the pt. obviously went to CT to rule out something... labs looked suspicious as well.... at what point did you stop playing "what's the diagnosis?" I'm saying this nicely (print is hard to "hear"). You've become task oriented yourself and seemed to have stopped trying to correlate labs, assessment and test results to anticipate the diagnosis and future care.

Some of it is on the MD, and welllllll , yes, some of it is on you to change too. It's so easy to focus on the tasks and stop thinking once we're comfortable and in a routine... the analytical part... the critical care thought process does stop and start with us, it is our responsibility.

So with much support to you, I suggest both talking to the docs and see if you can catch yourself not guessing the diagnosis. You can fix you easier than the docs, its the best place to start.

Been there done that too, some days I have to kick myself to think:innerconf