How comfortable would you be...

[LouisVRN]

How comfortable are you suggesting additional diagnostic testing to a doctor? We recently had a patient undiagnosed with multiple issues and were discussing some of his symptoms. I suggested a possible diagnosis to a co-worker of when I had seen similar symptoms before (rare condition). The charge nurse wanted the other nurse to suggest a diagnostic test to confirm/rule out the condition (lab test) and the other nurse didn't feel comfortable doing it. Had I been in that situation I think I would have left an anonymous dear doctor note suggesting the lab test and why I feel it was appropriate.

While I know it is not our job to diagnose our patients we have seen a lot. This patient currently was working with no diagnosis and the doctor on the case was new. Just wondering how comfortable you would be suggesting diagnostic testing to confirm rule out a diagnosis the doctor may not have thought of.

[Ruby Vee, BSN]

how comfortable are you suggesting additional diagnostic testing to a doctor? we recently had a patient undiagnosed with multiple issues and were discussing some of his symptoms. i suggested a possible diagnosis to a co-worker of when i had seen similar symptoms before (rare condition). the charge nurse wanted the other nurse to suggest a diagnostic test to confirm/rule out the condition (lab test) and the other nurse didn't feel comfortable doing it. had i been in that situation i think i would have left an anonymous dear doctor note suggesting the lab test and why i feel it was appropriate.

while i know it is not our job to diagnose our patients we have seen a lot. this patient currently was working with no diagnosis and the doctor on the case was new. just wondering how comfortable you would be suggesting diagnostic testing to confirm rule out a diagnosis the doctor may not have thought of.

i have no problem speaking up . . . making suggestions, asking for orders, advocating for my patient. it's part of our job.

[Twinmom06, ASN, APN]

BTDT..... some docs are very receptive- and then there are the distal GI outlet that refuse to listen to anybody's suggestion that isn't an MD.....but most are open if there's good rationale :)

that is the best way I've ever heard that put before!!! Myself I like cranial/rectal inversion syndrome!

[blondy2061h, MSN, RN]

Depends on the doctor, but the attendings I work with? No problem.

[CoffeeRTC, BSN, RN]

Do it all the time..but I worl LTC and the docs only come in once a week or so.

Its all in your approach. Ask and ask the rational behind it...not all docs are idiots and there many that would be willing to go along with what is suggested and offer a rational for not being in agreement.

Again....all in your approach.

[LouisVRN, RN]

I think my biggest fear in mentioning anything in this particular situation was the fact that the disorder that matched the symptoms is extremely extremely rare and I am not sure if the doctor would have even heard of it. I have had one patient with it before (in three years) and none of the other nurses knew of the disorder.

[kaliRN]

I would approach it just that way, "Dr. Such and Such, I had a patient with the following symptoms: * & ^ that are very similar to this patient. It turned out to be disorder X. Because it present so rarely, we only found out after running Y diagnostic. Would you like us to try that here?"

[N.U.R.S.E.]

Tread lightly depends on the dr ego and your wording use therapeutic communication and learn who's approachable and receptive for those who are not notice who they send cases to consult to and if their approachable ask their opinion in a round about general way the anonymous letter too. Most doctors have dr friends whom they respect pay attention to office politicswhen doing the round about way remember never use accusatory deragatory statements always accenuate the positive