How do you work????

Neuro Guy NP, DNP, PhD, APRN · May 23, 2011

#2 is an ideal situation. Being comfortable in such a situation is something all must learn to do because nurses are valuable members of the team. We should not complain about those doctors who do not listen but at the same time himhaul when asked our opinion about the situation (not accusing, just making a generalized statement). Nurses must be very vocal about concerns and suggestions/solutions to help achieve the best possible outcomes. We are not simply pill pushers or implementers or lackies. We have a voice - a strong one. Do not be shy about expressing your opinion - even when not directly asked. I don't go for the 'seen, not heard' type thing.

Get in there and advocate for your patient. Hope that answers your question. :-)

ParvulusPuella · May 24, 2011

It depends on the doctor, the patient, and what the problem is. If I have a patient throwing frequent pvc's and ectopic beats who hasn't had a Mag level drawn, I generally ask if it's ok to go ahead and get that level drawn. Then I ask if they want me to call back with the results or to give 1-2 grams IV if the level is

I have never had an issue with calling and telling the doc when I need restraints though. I've only ever needed them for ETOH detoxing patients, and all I need is for them to tell me what type of restraint they want- soft limb, leathers, etc. We always have at least 1 certified restraint rn on per shift, so they don't even have to come to the floor unless they are already up (I work nights so generally they are asleep)

Then there have been times where I am calling about pain medication, and the doc asks me what I want, and I am pretty much like, "uh, I called you, you're the doc, I don't know what you would be comfortable rx'ing in this scenario".

There's pretty much just one doc that we all dislike having to call, because half the time he doesn't care about what we are telling him, and the other half the time he makes you feel really stupid. He's an old-school doc, so that may explain it.

Flo., BSN, RN · May 24, 2011

I love collaborating with Md's and the rest of the health care team. I have no problem telling a doc this is the test, med or procedure that the Pt needs. I also have no problem telling the doc I have no idea what is going on but something is wrong.

ErinS, BSN, RN · May 24, 2011

I learned to give report to MD's using SBAR, which is a common report system that includes your 'R'-recommendation. I generally call my doc (I work hospice) with a specific order in mind, and usually he agrees, and sometimes he doesn't. If I am not sure what is going on then we go on a joint visit together and try to figure it out together.

evolvingrn, BSN, RN · May 24, 2011

I always know 'what' i want before i call. if i don't know 'what' i want because its a complicated situation i will consult with my charge first for additional imput. like pp, I am also a hospice nurse and our imput is generally expected. it's a field with a lot of autonomy. I'm pretty conservative in what i request and Almost always they go with what I suggest but if they don't its okay too.

EmergencyNrse · May 24, 2011

quote=mnrb_mdn;5164319-

example 1, you have called the doctor a couple of times and you are telling him the assessment of the patient and you just know something is not right. he does not pay attention to your concerns.

depending on what's going on call the rapid response team or call a code.

rapid response team puts extra "eyes on patient". never wrong if you don't feel somethings right.

(or you may want to call a code and stand in the hallway screaming. both work but the "code" is more fun)

example 2, a doctor is asking you so what do you think we should do. do you feel confident to let him know or not.

i tell him that he took all those extra classes... passed all those extra tests... if he can't figure it out he should call someone more competent. he's the one with md/do by his name. (you did say he didn't respect your opinion anyway)

LouisVRN, RN · May 24, 2011

I always feel confident to let the doctor know what I want. If I didn't know what I wanted I wouldn't generally call.

Even if a patient just doesn't seem right you need to have an idea of what to do. Do they seem to be going septic? Do they already have BC/UC, PCXR, broad spectrum antibiotics? Are you afraid of post-op complications - do you need a CT scan?

mnrb_mdn · May 24, 2011

yes it did and thank you very much, this website is helping me deal with the stress of becoming a nurse.

Anna Flaxis, BSN, RN · May 24, 2011

Example 1, you have called the doctor a couple of times and you are telling him the assesment of the patient and you just know something is not right. He does not pay attention to your concerns.

Then you document that you contacted the MD and there were no new orders, and you take it to your charge nurse. If you really feel something is not right, you have to speak up.

Example 2, a doctor is asking you so what do you think we should do. Do you feel confident to let him know or not.

Yes.

3dayRN · May 24, 2011

If a doctor asks me what I think we should do, my opinion is YOURE the doctor. I will give you my assessment findings and YOU tell me what to do from there. I can just hear it now from some of the other nurses on here but seriously I called the doctor about a problem and he is expected to find the solution.

KellyRPNinOntario · May 24, 2011

I called the on-call doctor at my LTC facilty a while back. I was lookin to get an order to send a resident to the ER. After giving him vitals and the scenario he asked what was my "gut" telling me. I was so happy because it was just a feeling I had that was only partly supported by assessment info. He had confidence in what I was asking of him. YES I would tell any doctor what I felt was needed...he is a big boy who can ultimately decide. Who knows these residents like we do???