Communicating with doctors as a new grad.

Nurses New Nurse

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As I have mentioned in other posts before, I am currently a new grad in a new grad residency program.

We have spent an entire week in sim and going over situations that often occur in the ER and what to anticipate with each patient. Additionally, we have been asked to come up with our own orders to ask the doctor.

My question to you all is, do doctors really expect nurses to call them and say "hey doc I would like a lasix drip, heparin and morphine stat?"

When I worked in the ER throughout the program, I didn't often see nurses giving doctors orders on what they wanted for their patient. Of course they would ask for pain meds, which is typical, but to actually know exactly what dosages and everything for a code situation, or for an urgent situation seems like more of a doctors job.

Can I get some input on this? As a new grad, I want to make sure I am prepared, but I also want to make sure that I do not embarrass myself by asking the doctor for an order that they laugh at.

Let me know your guys' input.

Specializes in FNP- psych, internal med, pediatric.

ER specifically....as some others suggested, SBAR to begin with, with a review of meds and how much the patient is already taking/being given will guide the physician to make further changes if warranted. Remember new grads, if you don't have a trend of BG's, temps, or O2 sats, why would you expect a change in orders or make suggestions in the first place? You need to have that information available to guide decisions. Also for ER, you follow the guidelines/protocols, if you haven't started there, example- MI protocol per se, aspirin, O2, IV lock, etc, then let the provider know, I followed MI protocol, here's what I'm looking at now so what would you like to do? Hope this helps!

Specializes in Tele, ICU, Staff Development.

You do have to know what you expect the provider to order...or else you won't know if you don't get it! :)

Since I've stared traveling, I've learned that this is totally facility/culture specific. I've worked in places where it was not only encouraged for nurses to give their recommendation, but expected...the resident was waiting for it, and if I didn't give it, he or she would ask, "well, what do you think it most appropriate?" (I LOVE these hospitals, but they are few and far between.)

A few assignments ago, I called the docs and said, "Blah pt is having this, I did this, here was the response, I'm going to give this, if it doesn't work I'll give this, K?" That was my experience. I was freaking BLASTED. Like, how dare I suggest a course of action, as the lowly nurse??

Where I am now, about half my patients are teaching, half aren't. The residents are fabulous, and we collaborate and work well as teammates. The PAs on the specialty teams are full on egotistical jackassess. Weird, cause usually PAs are super receptive to suggestions and good relationships with nurses.

My point is, feel out the egos wherever you are. Some places will appreciate your input, some won't.

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