How do you deal w this?

[elizabells, BSN, RN]

Okay, so I'm a student, and I need a little input. I don't want to give too many details (HIPAA, dontcha know) but basically, my preceptor and I caught on to a complication yesterday, and had to pretty much bully the attending into getting on board. Which she finally did, 24 hours later (today). So we moved the baby (I work into a NICU) from her open crib to an isolette, and when the parents came back from lunch they obviously knew something was up. But the MD had forbidden us to say anything. And then she went to a meeting. So we're sitting there, the parents are freaking, and asking questions, and we have to hem and haw. So the attending finally shows up, and tells the parents how "lucky" it is that "we" caught this so "early". I just about had a heart attack. Okay, obviously she's not going to say "the nursing student and her preceptor totally figured this out yesterday, but I was stubborn and so we didn't dx it for a full day", but for Pete's sake!!! So now I feel like the parents aren't going to trust us again because we were forced to stall them and then the MD came in like a brilliant angel of diagnostics. I get that this is the way it is. It sucks, but it is what it is. So my question is, how do you deal with it? How do you deal with having your professional skills totally ignored and never getting credit for anything? I'm not saying it should be about me and my pride, but how are we ever going to gain the respect we deserve when we get put into this kind of position, of having to tell lies of omission this way? GAAAAHHHH!!!

[beautifulb]

Well it's kind of hard. We are in between a rock and a hard place. As nurses, we aren't supposed to give results of lab tests, etc, and reasons for things that you describe. It is hard, I would kind of stall them too. Give them general information. It's really up to the doctor.

[burn out]

Just remember that nurses are not allowed to diagnosis but we can paint a pretty picture and let the family name it what ever they want. We can voice what our concerns for the patient are just as long as we don't give it a name.

[SharonH, RN]

You are not legally allowed to diagnose but you most certainly tell them something! Are you saying that while the parents asked questions, you said nothing and basically told them that they had to wait for the doctor? And she forbade you to say anything? That's crapola. You could say, your baby had a change in condition and you could certainly describe her symptoms. You could also say, we moved her to the isolette to allow her to _____(I know absolutely nothing about NICU). You could have then said, that only her physician could explain the results of the diagnostic tests and her new diagnosis.

So the bottom line is that that is not "the way it is" and the docs cannot "forbid" you to say anything. You cannot diagnose and interpret diagnostic tests but you do not have to pretend to know nothing either.

[TazziRN, RN]

Unfortunately, because of that brilliant doctor, those parents may well have trouble trusting ANY nurse. You could have told the parents what was going on without making the doc look bad, by saying "Your baby was doing this/that/whatever and the doctor wants her in the isolette for treatment." Nowhere in there does it say that you actually caught it the day before and the doc sat on it for 24 hours.