I want to thank everyone for the input. I spoke with my manager today. She said the medical director and administration are dealing with this issue and hopefully "something" will be made available in a couple of weeks.
She said the doctors are now beginning to fight among themselves (obviously many of them do not want to be called at all hours of the day - and night!)
She also said that we (the nurses in my unit) will be covered by ACLS only if the patient crashes. For example, if a patient's blood pressure drops, we can no longer give fluids and start dopamine - like we've always done. All we can do is tilt the bed and give fluids. No dopamine unless the patient actually crashes and we must open the cart.
Also, no more IV pushes of morphine for chest pain or prior to pulling sheaths following heart caths unless there is a written order.
I have a feeling this mess is going to take a while to sort out! Perhaps Dr.---- was correct when he said "You know, if some of these doctors don't smarten up, we may end up losing some patients..." I find this quite distressing. How can I sit and watch my patient die because the darn doctor didn't write orders or refuses to call back???
A few weeks ago a nurse was fired for writing a doctor's order. The order was for an OTC medication. When the doctor found out she wrote the order without asking him, he called the state nursing board and JCHACO. State board took this nurse's license away - permanently. JCHACO is "investigating" (going over charts, etc. etc.)
Management tells us to call the doctors for ANY order, no matter how "trivial". A few days later we're told "Well, you know that he (the doctor) never fills out the pre---- orders, but you know what he wants...." Or else you're advised to go to a unit where the doctor is well-known and the nurses there will tell you what boxes you should check - based on the doc's preferences/habits.
Ok, so here we have mixed messages.
I want to stop writing orders for the doctors who are too lazy to call you back, for the doctors who tell you "You know what I want". So I started to call them ("Dr.--, you wrote transfer orders. Do you want to continue the same meds?")
Many nurses say they will continue to write the orders for the doctors they know well, those who will not raise a stink about it. So I'm now in the minority, I'm the "stick in the mud", and I feel torn. What would you do?
We haven't heard the hospital official position on this dilemma. It does appear to me, however, that they're not willing to sit with the medical staff and tell them to start doing their job. I'm sorry, but I do not believe for a moment that a doctor will stand behind you if "something" should happen. The way I see it, when push comes to shove, the doc will stand behind you to kick your behind in order to save his/hers.
Sorry for the long post. What do you suggest I do?
I want to thank everyone for the input. I spoke with my manager today. She said the medical director and administration are dealing with this issue and hopefully "something" will be made available in a couple of weeks.
She said the doctors are now beginning to fight among themselves (obviously many of them do not want to be called at all hours of the day - and night!)
She also said that we (the nurses in my unit) will be covered by ACLS only if the patient crashes. For example, if a patient's blood pressure drops, we can no longer give fluids and start dopamine - like we've always done. All we can do is tilt the bed and give fluids. No dopamine unless the patient actually crashes and we must open the cart.
Also, no more IV pushes of morphine for chest pain or prior to pulling sheaths following heart caths unless there is a written order.
I have a feeling this mess is going to take a while to sort out! Perhaps Dr.---- was correct when he said "You know, if some of these doctors don't smarten up, we may end up losing some patients..." I find this quite distressing. How can I sit and watch my patient die because the darn doctor didn't write orders or refuses to call back???
A few weeks ago a nurse was fired for writing a doctor's order. The order was for an OTC medication. When the doctor found out she wrote the order without asking him, he called the state nursing board and JCHACO. State board took this nurse's license away - permanently. JCHACO is "investigating" (going over charts, etc. etc.)
Management tells us to call the doctors for ANY order, no matter how "trivial". A few days later we're told "Well, you know that he (the doctor) never fills out the pre---- orders, but you know what he wants...." Or else you're advised to go to a unit where the doctor is well-known and the nurses there will tell you what boxes you should check - based on the doc's preferences/habits.
Ok, so here we have mixed messages.
I want to stop writing orders for the doctors who are too lazy to call you back, for the doctors who tell you "You know what I want". So I started to call them ("Dr.--, you wrote transfer orders. Do you want to continue the same meds?")
Many nurses say they will continue to write the orders for the doctors they know well, those who will not raise a stink about it. So I'm now in the minority, I'm the "stick in the mud", and I feel torn. What would you do?
We haven't heard the hospital official position on this dilemma. It does appear to me, however, that they're not willing to sit with the medical staff and tell them to start doing their job. I'm sorry, but I do not believe for a moment that a doctor will stand behind you if "something" should happen. The way I see it, when push comes to shove, the doc will stand behind you to kick your behind in order to save his/hers.
Sorry for the long post. What do you suggest I do?