Published Sep 21, 2004
Nellie Nurse
58 Posts
Wondering if anyone can offer advice for a new RN on how to handle new MD interns who when you call them for an order can't make a decision and ask you what you think they should order, what is usually done, etc. I want to say, "I don't know, you're the one with the MD after your name." If I was more experienced and I knew the hospital system better I would ask them to order specific things but being new I don't know what is normally done in certain situations I really don't know what to say. It's kind of frustrating.
Had an MD intern the other night who admitted a LOL with Dx of weakness. Patient had IV running at 120/hr. Only voided 150cc in 8 hours. Did a bladder scan which showed approx 300 cc post void. Lungs sounded ok, pt wasn't uncomfortable, etc. I figured that she was probably dehydrated and catching up. Called the dr though to tell her about the low output. She ends up hemmin and hawin about "what do you usually do, what do you think I should order........gee, I don't know" . Just makes me want to pull my hair out with frustration. Finally doctor decides that an indwelling cath would be best. By that time it was the end of the shift so I had to pass it on to the next nurse. I'm just not sure if that was an appropriate order or if it would have been best just to wait a little longer and see if her urine output would catch up.
This is not the first time this has happened to me. I'm the nurse, you're the doctor. Make up your mind and give me an order !! :)
Thanks for your ideas.
nursbee04
223 Posts
I am a new nurse and I have the exact same problem when I call for pain meds.
If I know I am calling a new doc, say, for a patient with chronic pain who doesn't have PRN's ordered (this happens a LOT on my unit). I'll ask the patient what they take at home for this type of pain ("Percocet") or I'll look at their daily home meds, because I know they're going to ask me what I think would work, and frankly, I've not been a nurse long enough to be able to say, unless they are a frequent flyer.
Its very hard as a new nurse to be put in this position. I really hate when they say "What do they usually do for that?" I had one new doc say "What do you want me to do?" Sometimes I know what I want when I call and sometimes I have no clue or suggestions.
Ruby Vee, BSN
17 Articles; 14,036 Posts
Why not just tell them that you're new, too, and you don't know?
Really, though, it's a good idea to have an idea what you want when you call a doctor. If you don't know, how will you know if the order you recieve is appropriate? I know you're busy and you have thousands of things to do, but if you can, do some research or ask another nurse or the charge nurse before you call the doctor.
RNPATL, DNP, RN
1,146 Posts
Hey ... we were all new at one time and yes, that even means physicians. Often, I try to have an idea of what kind of order I would like when I call the physician. For those new nurses, it might be a good idea to review the patient quickly with a more experienced nurse to see what they think would be appropriate for the patient.
I have had several situations where I received an order from a resident that I questioned. I would say, Doc - are you sure you want me to give this dosage? We all have to remember that we were all new once and cut the doc some slack. We are all part of the health care team. Just because you are a nurse does not mean you don't know what should be ordered. Many times you do know what needs to be ordered. As you grow in your experience, it will not be AS frustrating ..... but there will be times!
Sadie04
204 Posts
Hey ... we were all new at one time and yes, that even means physicians. Often, I try to have an idea of what kind of order I would like when I call the physician. For those new nurses, it might be a good idea to review the patient quickly with a more experienced nurse to see what they think would be appropriate for the patient.I have had several situations where I received an order from a resident that I questioned. I would say, Doc - are you sure you want me to give this dosage? We all have to remember that we were all new once and cut the doc some slack. We are all part of the health care team. Just because you are a nurse does not mean you don't know what should be ordered. Many times you do know what needs to be ordered. As you grow in your experience, it will not be AS frustrating ..... but there will be times!
Well put - who knows, we nurses may even teach those green residents a thing or two!
meownsmile, BSN, RN
2,532 Posts
Exactly what i was thinking,, review the patient with your resource person on the unit with you. Check the patient for any allergies before you call. Make sure you have your latest labs with bun/creat levels availiable and the latest set of vitals. Hope the doc is actually awake if you are calling at night, and after you actually take an order review it again with your resource nurse first. If it doesnt seem right, call him back and have him verify that is what he wants to do.
directcare4me
173 Posts
Why not just tell them that you're new, too, and you don't know?Really, though, it's a good idea to have an idea what you want when you call a doctor. If you don't know, how will you know if the order you recieve is appropriate? I know you're busy and you have thousands of things to do, but if you can, do some research or ask another nurse or the charge nurse before you call the doctor.
Exactly what I was going to say. New doctors are just as "new" at this medicine thing as new nurses are. Nothing wrong with it. I second the idea of running it by a more experienced nurse whose opinion you trust, and then call the doc.
nursenatalie, ADN, RN
200 Posts
I had excellent nurses who helped me along when talking with a resident, they would talk the situation over with me before I called and I always had an idea what would help before calling. There are certain things I have learned over time,for instance, I will not accept an order for Phenergan for nausea if the patient is over 65, have had too many flip out to go down that road again. It wont be long and you will start seeing what works and what doesnt. I can call a surgeon and tell him that this pt needs an NG tube and all but one will take my word for it without question. I may have converted the one surgeon who disagreed that his pt had an ileus and I proceeded to call the other surgeon when call time changed, put an NG down this poor man and received an IMMEDIATE 2000cc return!