Don't do the physicians work!

Nurses Relations

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Please nurses, stand up for yourselves and the patients! Healthcare is evolving to the physicians doing hardly anything and putting all responsibility on the nurse. I feel the shift is for the doctor to spend less time with patients so they can see more pt's which only equals more money for doctors. Conflict of interest in my opinion.

You have the right to say no to physicians and point out why certain situations require action from the MD and not the nurse. I will make a list and if you have something else to add please do.

1. Physicians still giving verbal orders - this has been noted as a national patient safety issue. So why can't the physicians protect patients safety? Are doctors truly concerned with pt's safety? If they are ignoring pt safety goals then I'd say no they aren't.

2. Why are nurses now responsible to make sure certain medications or therapies ordered such as Metoprolol or VTE prophylaxis? Nurses are getting burned because physicians aren't capable of being thorough enough to make sure they have ordered what is appropriate for their patient. This is just lousy of physicians in my opinion.

3. Nurses having to get physicians to renew 24 hour restraint orders and foley cath orders.

If your physician does not know the pt is in restraints or has a foley catheter that requires a new order then they are not fully aware of the pt they are managing care for and is not professional.

4. Physicians are not giving report of their patients when another physician is taking over call. Calling a physician for help with a pt issue and the MD has no clue who you are talking about is poor physician management in my opinion and is a safety issue.

If you want to elaborate on what I've mentioned or have some of your own similar situations please add as I'm interested in others opinions.

Thank you,

RN

Specializes in ICU, trauma.
Yes you are BSN16! The goal is to eliminate ALL verbal order entry by nurses! ALL!! The doc can put in the Levophed order himself when he takes his ass to a computer or chart. Stop kissing ass and keeping us from getting physicians on board with the system and technology where they should be sweet cheeks!
This is the second time i have seen you refer to another female as "sweet cheeks" on AN forum. It is truly strange how you are advocating respect for you and you fellow nurses while simultaneously degrading them.
Specializes in OR, Nursing Professional Development.
Yes you are BSN16! The goal is to eliminate ALL verbal order entry by nurses! ALL!! The doc can put in the Levophed order himself when he takes his ass to a computer or chart. Stop kissing ass and keeping us from getting physicians on board with the system and technology where they should be sweet cheeks!

No, waiting for a physician to put in an order on a patient who is crumping is putting patient safety in danger. I take verbal orders all the time because expecting a surgeon to drop scrub and put them in himself is a danger- more time on cardiopulmonary bypass is not a good thing. Eliminating all verbal orders will never happen. Yes, there are times when verbal orders can wait until the physician or other provider with privileges puts them in the computer, but there are also times where verbal orders are indeed warranted. The goal should be to reduce verbal orders to times when only necessary such as when a patient's condition is changing rapidly and any delay of care can result in compromising patient care or when a surgeon is scrubbed, not to eliminate them completely.

Also, might I suggest that you reread what you type before posting? You are coming across a bit strong, and some of the names you are referring to others as ("sweet cheeks") is downright rude and reduces your credibility.

No, waiting for a physician to put in an order on a patient who is crumping is putting patient safety in danger. I take verbal orders all the time because expecting a surgeon to drop scrub and put them in himself is a danger- more time on cardiopulmonary bypass is not a good thing. Eliminating all verbal orders will never happen. Yes, there are times when verbal orders can wait until the physician or other provider with privileges puts them in the computer, but there are also times where verbal orders are indeed warranted. The goal should be to reduce verbal orders to times when only necessary such as when a patient's condition is changing rapidly and any delay of care can result in compromising patient care or when a surgeon is scrubbed, not to eliminate them completely.

Also, might I suggest that you reread what you type before posting? You are coming across a bit strong, and some of the names you are referring to others as ("sweet cheeks") is downright rude and reduces your credibility.

Guess what? Get the verbal order and initiate it but the physician must put in the order himself/herself eventually otherwise you leave room for error. Its not rocket science Ma'am! That better for you?

This is the second time i have seen you refer to another female as "sweet cheeks" on AN forum. It is truly strange how you are advocating respect for you and you fellow nurses while simultaneously degrading them.

Yea, avoid the topic content and aim at the "sweet cheeks" comment. LOL.

By taking a verbal order and confirming it with a read back I am not putting a patient's safety at risk nor am i exercising bad habits in health care. In fact this is in my job description.

For example throwing a fit because a physician gave you a verbal order for stat levophed is putting a patient at risk.

This is part of the job of an RN. Stop crying because you have to do your job.

A nurse has the right to refuse putting ANY order in if they do not feel it is safe.. Verbal orders are deemed UNSAFE by JCAHO...Smile! :-)

Specializes in OR, Nursing Professional Development.
Guess what? Get the verbal order and initiate it but the physician must put in the order himself/herself eventually otherwise you leave room for error. Its not rocket science Ma'am! That better for you?

Verbal orders in certain situations are allowed. The physician must co-sign the order in my facility, within 24 hours. The facility is indeed accredited by the Joint Commission, so clearly there is an allowance for this. I think you are misinterpreting the goal of verbal order reduction. Also, you really need to reevaluate your posts. You are coming across as rude and condescending. That is not a way to have a respectful debate.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Guess what? Get the verbal order and initiate it but the physician must put in the order himself/herself eventually otherwise you leave room for error. Its not rocket science Ma'am! That better for you?
You are still rude. Still don't get it. You are riding a thin like that borders on TOS violation. I would review what you are writing and change the tone and words. I bet you are difficult to work with, too.
Specializes in ICU; Telephone Triage Nurse.
That sounds amazing. We use Doc Halo which is also a secure text message system however we are not able to receive orders this way...so basically pointless lol

It's pretty sweet, but we are dealing with clinic patients (i.e., primary care) not bedside care … Doc X somehow didn't get Rx Y to pharmacy - now mom is fruitlessly waiting for a Rx which never arrived and it is now after clinic hours (you gotta love E-Rx'ing) … or pt Q under estimated their regular insulin usage now has 1-2 doses left on Saturday night.

It is handy, but trust me, snark from an on call provider comes through text messaging loud and clear. :blackeye: :madface:

You are still rude. Still don't get it. You are riding a thin like that borders on TOS violation. I would review what you are writing and change the tone and words. I bet you are difficult to work with, too.

................

I just looked up the definition for "sweet cheeks" and opps..Honestly didn't know it meant that so I apologize for who ever I offended.

Specializes in Adult Internal Medicine.
Healthcare is evolving to the physicians doing hardly anything and putting all responsibility on the nurse.

I know you are upset, but do you really think this is the case? Do you feel you have a good idea what the daily workflow of a hospitalist is? Have you ever asked to spend a say shadowing a hospitalist? Its similar to the threads that pop up about CNAs calling RNs lazy because they do all their work.

I feel the shift is for the doctor to spend less time with patients so they can see more pt's which only equals more money for doctors. Conflict of interest in my opinion.

This may be true, but it's not because it equals more money for the doctors, it equals more money for the administrators. If you think about it from a business model perspective, nurses are a huge non-billable expense: the more work you can make your non-billable employees take off the hands of your billable employees the more money you make. Take your complaints to them rather than driving a wedge between members of the healthcare team.

That being said, there are some lazy providers out there just like there are lazy RNs out there.

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Specializes in SICU, trauma, neuro.

Meh...on the off-shifts a single ICU resident is responsible for as many as 20 critically ill/injured people. I am responsible for at most, two. I think I can give them a break if the restraint order needs to be renewed. :yes:

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