I'm not the doctor! - page 2

Recently my husband's grandmother was a patient in the ICU. I am frequently used as the medical translator in the family, this time wasn't any different. I had the opportunity to make a couple of... Read More

  1. by   chillnurse
    I think the big misconception is that all smart people to go medical school and advanced practice, which is also false. The big gap in knowledge comes from the continual pounding of our knowledge base that we take on a daily basis. When forced to use knowledge more often, we will become more competitent. I am sure if any of the RNs on this forum took the pounding we take as providers for several years, they would be just as comp. at the job of a provider. One's career molds their intelectual ability. Hence why I can't spell without spell check.
  2. by   dudette10
    Quote from sweetdreameRN
    Nurses have a huge amount of responsibility. Of course we have many reasons we didn't go to medical school, but less responsibility should not be on that list. Even if you think the physician is legally responsible, you have a moral and professional obligation to ensure that every action taken by the physician is in the patient's best interest as the patient's advocate. The "I don't want that much responsibility" response makes nurses look lazy and uneducated. We aren't.
    Um, what? It's a damn good reason for not becoming an MD in the context the poster you replied to used it. You changed the meaning of the phrase in your reply.

    I'm a nurse, I love my job most days, and I'm not insecure in my role. I have no desire to be a provider because it IS too much responsibility. Just because I believe that does NOT mean that I fail to fulfill my role as a nurse. Frankly, I don't follow your logic.
  3. by   chillnurse
    after reading the phrase "make sure every action taken by the physician is good for the patient" I have come to the conclusion that the OP has probably been cussed out continually for questioning sound orders. Lol
  4. by   chillnurse
    Quote from TU RN
    If every physician order was executed by the nurse without question, some nurse would have given 50mg of IV (that is, not PO) hydralazine to a hypertensive patient and likely killed them or stroked them out because the physician "thought it was 1:1." Or they might even have given 6mg adenoside to a symptomatically bradycardic patient, instead of 1mg atropine since the young doc must have mixed the two "a drugs" up. The MD mistakes we catch are huge, and great harm could result if it wasn't for the "second set of eyes" that are nurses.

    Yes I do believe physicians and nurses should have ongoing professional and respectful conversation for the good of the patient. I also wish I got more credit for the knowledge that I have (although I do acknowledge the greater knowledge of physicians). However, I do not want the responsibility (and with it, accountability) of a physician. At least not as long as I'm being paid or respected as little as I am as a nurse.
    We have a pharmacist for that
  5. by   RNperdiem
    When a patient or family starts asking questions about their medical plan of care "what are the chances of recurrence of this tumor", I will refer them to the doctors.
    If the patient has questions about things nursing related, I can answer questions about the use of the incentive spirometer, the importance of early mobility, things to know about pain control.
  6. by   not.done.yet
    The doctor's role is to investigate, diagnose and treat the disease itself. The nurse's role is to help the patient live within all of the above and ensure the patient is both safe and monitored.

    Totally different roles. Both extremely important to the patient. I can be valued for what I do without having to go into competition with the MDs, PAs and NPs. I just don't need the chip on my shoulder. Each needs the other and there is nothing wrong with saying " your doctor will be better able to answer that than I".
  7. by   sweetdreameRN
    The OP has an excellent working relationship with many amazing physicians. I also don't hesitate to question an intern...or an experienced attending for that matter if I don't think the order is for the best of the patient.

    You certainly misinterpreted my quote. What I said is the job of every nurse.

    Additionally, I have never been cussed out by a physician. That is unprofessional and inflammatory behavior and would NOT be tolerated. How are we supposed to have Collegiate Interactive Teams (see "Why Hospitals Should Fly" by John Nance) if we allow such behavior?
    Last edit by sweetdreameRN on May 15, '14
  8. by   sweetdreameRN
    Quote from chillnurse
    We have a pharmacist for that
    OMG. I cannot even explain how uncomfortable your comment makes me. Google "the swiss cheese model" related to patient safety. The bottom line of that theory is that we are all human and prone to error (you could also read "To Err is Human") and must have multiple double checks in a high-risk industry such as health care. We can't just assume someone else will take care of it and move on. That is how adverse events happen.
  9. by   HappyWife77
    It's best to KNOW what you KNOW....then simply find out for them if necessary things you don't know or that they need to see the doc for....or what we need to contact them for. We're hands on and once the doctor knows the nurses, They will usually take in to consideration our suggestions anyways.

    Doctors are human just like us.
  10. by   sweetdreameRN
    Quote from chillnurse
    medicine and nursing are both challenging professions. But the amount of knowledge required to practice medicine is much much greater than to practice nursing. I am not saying nursing is easy, but too many nurses have the attitude that they could do everything the doc can. So 3 years of RN school equates to 4 years of med school and 3 years of residency? No, it does not. I worked as a nurse on many different units prior to becoming an np. even being an NP requires much more knowledge than a staff nurse. It is just common sense. I am sure there are very smart nurses out there and not so smart nps and mds, but overall, the doctor WILL know more. If you refute this you are just plain wrong and have not done both.
    I certainly didn't mean to imply that the education MDs have is somehow not significant. My point is that we are all important integral parts of the care team, just as the pharmacist, the RT, etc. Often, the primary nurse does (and should) know a lot about his or her specific patients. A good physician can rely on a good RN to fill him in on many issues he might not be aware of since he has 20+ patients!

    Additionally, I will make the argument that an experienced ICU nurse has as much working knowledge to treat patients as a first or second year resident. The nurse may not be able to describe each metabolic pathway, or the physiopharmacology of each drug, but certainly knows what the appropriate treatment is MOST of the time. I don't want you to think that I don't respect physicians or consider them a very important part of the team. I just don't want nurses thinking that their knowledge and experience are not worthwhile and important as well.

    Thanks for your comment.
    Last edit by sweetdreameRN on May 15, '14
  11. by   TorresFNP2b
    I have worked with both respectful physicians and rude, condescending, arrogant physicians, and I have to say that how each treats and interacts with us nurses does impact the level of pride I feel in our profession. Mutual professional respect is key. Unfortunately though there are still many docs and patients who will always see nurses as "less than" so we have to try not to see ourselves that way.
  12. by   OCNRN63
    Quote from emtb2rn
    My standard reply when addressed as "doctor" is: "i'm not the doctor, i'm your nurse, i work for a living".
    Why the need to denigrate another member of the health team? Doctors work very hard, too.
  13. by   calivianya
    Quote from chillnurse
    We have a pharmacist for that
    Whoa, really? Jeez, are these the same pharmacists that that send a communication through the computer for you to clarify why a patient takes colace at home? Or what the indication for PRN simethicone is? You really trust those people with your patients' lives? I don't think I'd trust them with house plants. Just saying. I get that it's just protocol that makes them send that communication about what the PRN meds are for, but when you are talking about an acid reducer, a gas medicine, or a stool softener, you'd think they'd be able to put the medication into the system without calling for clarification.