RN's accountable for MD's? What do you think? - page 2
As an RN on a med surg unit your manager tells you that according to the plan of care for stroke te patient is to get test A, B, C on day 2, and get started on meds A, B. You are to see that the docs... Read More
Oct 22, '02Occupation: registered nurse Joined: Nov '01; Posts: 1,083; Likes: 14pretty much always been that way around here. somebody needs to baby sit them i guess it might as well be a nurse
Oct 23, '02Occupation: RN Joined: Nov '99; Posts: 2,950; Likes: 619Nursing management needs to sit down with the doctors and work this out.
You are not responsible for a Doctor's practice.
We do reminde Docs to wash hands politely but if he doesn't then it needs to be addressed by management. If a Doc is chronically violating rules then again management needs to address this. If they are not signing orders etc. They can loose privileges. Management is passing the buck. Probably because they do not know how to aproach this with the Docs. Bottom line is the Doc's are out of line and they need to be disaplined not you. If they want to practice there they need to follow the rules. Doctors do not want to loose privileges they will comply if forced to. You do not have the power to force them management does.
Oct 23, '02Occupation: MHN Joined: Feb '02; Posts: 118; Likes: 2Canoehead, ? were the verbal orders from the Unit Manager backed up by any written documentation from management and was it signed off by management.
Where ever I have worked always edicts ,protocols ect have had to be signed off.
The only time I have ever seen standing orders like you are describing they were developed as a clinical pathway that the nursing staff and attending physians/surgeons had developed together and were set out dealing with specific for each procedure
Oct 23, '02Occupation: onc/heme rn Joined: Oct '01; Posts: 523; Likes: 37just another job for the already underpaid and overworked nurse to perform. i agree with the previous posts....a standing order or caremap should be signed by the doctor. most docs don't appreciate your suggestions...can't wait to see their response when you tell them they have to do something, let alone chart on why they are not. one of our docs is infamous for throwing away nurse's documentaion/charting when he unsatisfied with how the nurse portrayed him...eventho it is usually right on...the guys is a meanie (for lack of better word!)
Oct 23, '02Occupation: midnite RN Specialty: cardiac ICU ; Joined: Jun '02; Posts: 230; Likes: 120So basically, nurses at this facility are going to be the targets of hostility from MDs who don't want to be told what to do? THIS IS THE JOB OF ADMINISTRATION. If they want to dictate to the physicians, it's cowardly of them to stick the NURSE with this job. Administration is afraid of pizzing off the docs, because they admit patients and hence make money for the hospital. HOWEVER, if there are no nurses to care for patients docs want to admit, where does that leave them? I mean, duh.
Oct 23, '02Occupation: Psychiatric Research Joined: Aug '02; Posts: 1,467; Likes: 6What, exactly, are your docs getting paid the big bucks for? Sheesh!
Oct 23, '02Occupation: RN Joined: Dec '00; Posts: 826; Likes: 16Following signed written standard orders is one thing. However, you are not the doctor's keeper -- it is up to him/her to do his/her job. Get a written copy of your job description -- I'm quite sure "being accountable for MD to write orders" is not listed. As if you don't have enough to do.....
Oct 23, '02Occupation: caregivers, ushers to the portal of heaven Joined: Dec '01; Posts: 164; Likes: 1Shoving responsibility and liability for OTHER PEOPLE'S PERFORMANCE onto RNs is an unrealistic and abusive stress on already overworked nurses.
The day the RN is accountable ONLY for his/her performance, not any underneath or above, will be a big step forward in the respect nursing deserves.
More "babysitting or ELSE" duties like this shucked onto breaking nursing backs will just add to the retreat from the bedside.
Soon the average length of time a new graduate RN works as an RN before pursuing another field:
Oct 23, '02Joined: Oct '00; Posts: 8,729; Likes: 8,412We have preprinted orders that they just check off and sign, but are expected to follow up with the doc if he/she didn't check off what the pathway dictates.
I for one think that one group auditing another group just makes for friction between them, and leads to worsened patient care in the long run. I would certainly be upset if the housekeeping staff watched my practice and reminded me to document correctly on patient care that was given.
Oct 23, '02Joined: Jan '02; Posts: 5,673; Likes: 159Originally posted by KP RN
For crying out loud, Canoe!! Now, I've heard everything!
Next thing is that you'll be following the MDs to the bathroom to make sure they wipe themselves OK and wash their hands!
Is it any wonder some nurses get to the point they just nod their heads at administration, ignore them and and simply carry on...
Oct 23, '02Occupation: ob staff nurse high-risk referral center Joined: Apr '01; Posts: 320; Likes: 32Know the difference between God and a doctor? God doesn't think he's a doctor!!!!
Oct 24, '02Joined: Oct '00; Posts: 8,729; Likes: 8,412Thank you alll- sometimes we all need a little confirmation that it's the system, not us that's crazy. Now the question is- is this a battle worth fighting, or should we all just nod and ignore them?
Oct 24, '02Joined: Jan '02; Posts: 5,673; Likes: 159Hey, if you've got the energy to fight...go for it!! Maybe you can edumacate them and they'll actually listen to you...if you've got decent management.
Gotta admit I've been guilty of ignoring a silly administrative directive..and I've seen this kind of passive resistence work in time (and the more who participate the better it works.)