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Discussion

How much autonomy do nurses have??

Hi. Can you all tell me how much autonomy do nurses have??

Regular RN's?? NP's? Do they get to make decisions about the patient on their own OR are they just "pill pushers" just following the docs. orders?? No offense here, but how much autonomy do you have as a nurse in making real decisions that impact the patient; besides "caring" for the patient-- baths, pills, cleaning up, IV's, etc... Do you just follow orders OR make the decisions ourselves??? What about interpreting labs?? Tests?? Can you offer advice to the patients?? Or is all that up to the docs.?? Do the nurses just do the "caring" part?? That is important no doubt about it, but I am curious as to what else we can do... thank you.. E :o

Featured Replies

We're just pill pushers who follow docs orders.

:angryfire

Go look at your state nursing website for all the pill pushing details.

i can't believe you came to a nursing board to ask this! Curious or not, the wording was very poorly thought out and completely inappropriate.

i think the level of autonomity depends on the specialty area. for example, icu nurses have a high degree of skill sets. they have to be able to interpret what is going on with their patients, titrate drips accordingly to reach desired parameters set by physicians, and sometimes provide total care for their patients. i have seen code situations where the nurses are calling the shots to bring a patient back no doctors in site. this is why some places have standing orders or there is protocol. this allows the nurse to make independent decisions based on certain guidelines. in a lot of areas, the nurses are the ones that completely run the show so to speak. i am in critical care. we have to be able to interpret ekg changes, use our assessment skills to notify a dr if there are changes in condition, use our knowledge to know when to hold certain meds and when to give (ie antihypertensives, narcotics, insulins, etc). i know i just can't "push pills" all day. my license in on the line and i am responsible for my decisions, assessments, and actions in "caring" for my patients. i hope this helps.

We're just pill pushers who follow docs orders.

:angryfire

Go look at your state nursing website for all the pill pushing details.

i can't believe you came to a nursing board to ask this! Curious or not, the wording was very poorly thought out and completely inappropriate.

i have thought that this poster is either

a. a troll

b. someone who wants to be an rn but hasn't a clue what's involved....has delusions and is all talk

or

c. see a

epona- give it up. do NOT become a nurse. nope. you're not our kind and you wouldn't cut it.

I think, however possibly poorly-worded, we ought give the original poster the benefit of the doubt. Rude posts and inflammatory remarks are not tolerated on allnurses.com, per Terms of Service. Additionally, if you find a particular post or poster offensive, please choose the following options:

1. report the offending post/poster using the triangle reporting button on the lower left corner of the post....

*or*

2. simply ignore the post.

Thank you for understanding.

I wondered, too, at the harshness of the responses; then I went back and reviewed the OP's posting history. Here is someone who, in a very short span of time, has claimed to want to be a nurse, then she wants to be an NP, then she wants to try every medical field under the sun depending on how well they pay; but at the same time, she doesn't want any hospital experience, doesn't want to handle poop, and is deathly afraid of a needle stick. A week ago she was torn between a nursing diploma program and an MSN. Now she's asking if nurses are really just pill-pushers, or if they only (insert list of standard CNA duties). Clearly this is a person who has not one single clue about what it takes to become a nurse or why she has any business becoming one.

I don't really blame the respondents for getting irritated. Perhaps it's because we're mostly women, but we nurses spend too much time trying to be nice when it's not always warranted.

  • Experts
I don't really blame the respondents for getting irritated. Perhaps it's because we're mostly women, but we nurses spend too much time trying to be nice when it's not always warranted.
Your post was well-worded and refreshingly straightforward. :cheers:

I believe Epona is still considering nursing school as I have read this person's posts before. I'm an LVN student Epona and I can't answer the question of autonomy yet, but I would think that the further advanced you the more autonomy you would have, but I could be wrong. "With great power comes great responsibility" is what comes to mind for me.

From the outside looking in, it may seem that "pill pushing" may be all nurses do, but once you're on the other side, you see the light, there is an incredible amount of responsibility involved in being a nurse. Maybe having never met a nurse or been in the environment would lend this inference, I could see how that would happen. I hope you find your answer Epona.

Believe me, I understand the dubious nature of some posts and posters on the internet. That is why using the reporting system is so important. If you feel there is someone "trolling" the boards, a report will alert moderators to the situation and enable us to help take care of it. Calling posters "trolls" invites trouble and flaming.

Therefore, I would ask replies be politely worded, as well as realistic. We can "keep it real" without being rude. Thank you.

To the OP:

If you really are interested in nursing, a good way to learn is to shadow some nurses in a real life situation or ask these questions at a community college/university school of nursing. Or pick up a good occupations guide/handbook to get a very accurate description of what nurses do.

It is very unwise to go to a site of literally THOUSANDS of NURSES and use the term "pill pusher" to such people, when you want information or even to discuss issues. It really sets an awfully bad tone for you.

Hope this helps. And, good luck to you.

  • Experts
how much autonomy do you have as a nurse in making real decisions that impact the patient; besides "caring" for the patient-- baths, pills, cleaning up...
As a nurse I have never given a bath or cleaned up anything. My facility has great full-time housekeeping staff who clean up wonderfully. In addition, the facility has many hard-working CNAs who give all the baths and showers. I pass many pills; however, I am allowed to utilize my nursing judgment by not administering them if they're not needed. For example, I don't need to give antihypertensive pills to a patient if the blood pressure reading was low.

I am not going to reply as caustically as some of the other respondents. It is, however, advisable that you 'catch a clue' and word your posts with more sensitivity. Good luck with your decision (whatever it may be).

I believe Epona is still considering nursing school as I have read this person's posts before. I'm an LVN student Epona and I can't answer the question of autonomy yet, but I would think that the further advanced you the more autonomy you would have, but I could be wrong. "With great power comes great responsibility" is what comes to mind for me.

From the outside looking in, it may seem that "pill pushing" may be all nurses do, but once you're on the other side, you see the light, there is an incredible amount of responsibility involved in being a nurse. Maybe having never met a nurse or been in the environment would lend this inference, I could see how that would happen. I hope you find your answer Epona.

Very well-worded post. Thank you.

LoLz about the comment about nurses being mad and being women.:D:D

Yes, pill pushers is a bad name for our profession, especially since many of us have worked hard to get where we are.

That being said, if you want to have a high level of autonomy then you should seek becoming a MD, and not a nurse. Nurses although do have autonomy in making decisions depending on the situation, particularly if the doctor is not around, but for the most part Nurses and everybody else in the hospital, PTs, pharmacists, supply techs do gennerally follow the docs lead, that really is how it is, at least in the hospital setting.

But just because the doctor takes the lead does not mean our profession does not require a lot of skill or knowledge or that we make some decisions on our own.

Nurses are the ones that ensure the patients survive, like a gardian angel. The doctor for the most part just thinks of the solution as in what meds to give etc, nurses make it happen.

It seems like you want respect and money over helping people, and if this is the case you should not pursue a healthcare career, because it will be the patients who suffer.

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