Nurses expecting to do too much!

[CosmoRN77]

Hello there,

I have been a RN for 15 years now and there is something's that just gets under my skin and would like to know if anyone can relate.. As nurses at the bedside we have tons of responsibility and many tasks which I'm sure u guys are already aware of... Now here is my beef... More frequently I see where the hospital administration is pushing nurses to make sure the doctors are doing their responsibility such as making sure a post MI patient is prescribed a beta locker.. Now I'm all about nursing but I'll be damned if I'm gonna sit there and tell a doctor what he needs to be prescribing to his patients as he is the ultimate one responsible for medication reconciliation and proper medication ordering.. Another example is DVT prophylaxis... They are wanting us to make sure this has been done for patients.. Another no no for me.. I strongly feel this is overstepping our obligations as a nurse.. And I don't want to hear ANYONE mention well a "good nurse" would do this for the physician and patient.. Because I'm a damn good nurse but do not tolerate doing the physicians job.

Hope to hear some feedback!

Thank

[CosmoRN77]

I get the advocate part of nursing I promise but my point is that we can catch errors all day long but the question is why aren't physicians held responsible for this? And I'll repeat... Yes I know we catch errors and bring it to the physicians attention so why are they not held responsible? If a nurse catches a mistake or an omission why aren't the doc disciplined? The nurse definitely would be in trouble if we miss something.. Just does not seems right to me...

[BrandonLPN, LPN]

I'm not sure why you believe the doctor wouldn't be held responsible as well. I'd imagine he would be.

[AJJKRN]

I understand the frustration as it is just one more thing that really the MD's should be doing without nurses holding there hands to get it done. Missing an order here and there is one thing but now it's our responsibility to make sure the MD's aren't missing these things so we get payment from Medicare, etc. because hospitals are losing out on money reimbursements for MD fall-outs. Yes, it's in the best interests for the Pt but I don't see why there's such a backlash for a nurse venting and calling out the BS of the situation honestly.

[Coffee Nurse, BSN, RN]

I get the advocate part of nursing I promise but my point is that we can catch errors all day long but the question is why aren't physicians held responsible for this? And I'll repeat... Yes I know we catch errors and bring it to the physicians attention so why are they not held responsible? If a nurse catches a mistake or an omission why aren't the doc disciplined? The nurse definitely would be in trouble if we miss something.. Just does not seems right to me...

Who's to say the doctor isn't disciplined? If you have concerns about a specific MD repeatedly making the same errors, then you need to talk to his/her superior, or fill in incident reports, to make it clear there's an ongoing problem.

As to the nurse getting in trouble, unfortunately, that's part of being the last line as the bedside nurse; if we don't catch a mistake or omission, there's nobody between us and the patient to flag it up.

[AJJKRN]

Out of curiosity, how many responders have to do the core measure checklists at there facility that are monitored by non-nursing staff in quality control? Our MD's don't have to do them but they're the ones causing the issues with the fall-outs...just wondering

[GeneralJinjur]

You all make good points -- I think the irritation comes from this being seen as only a nurse's problem for not reminding the doctor of necessary orders that should be obvious, given the patient's condition.

No doubt docs are being reminded about this, but it's very likely you aren't going to see it happen. Their culture is so very different from nursing's.

[Horseshoe, BSN, RN]

Please understand that like it or not, in the event of a negative outcome resulting from a mistake of omission, the nurse can and will also be sued for negligence for the exact reason that it IS our responsibility to spot mistakes and take measures to correct them.

[KatieMI, BSN, MSN, RN]

My patient - my job. Period.

Besides, if, say, the PCP will forget that DVT prophylaxis and then Surgery comes, they will be upset, the surgery will possibly be delayed till they sure that there is no HIT, INR is where it belongs, etc. And, the cherry on the pie, I will have to speak with the said PCP, quite probably 5 min. before shift change. Do I want this mess? No.

I will put orders in instead of doc, because I can get pharm ladies right away and get the drug to the patient WAY quicker.

I will even tactfully "suggest" actions and lack of them, so that my patient with ESRD with dialysis, CAD with stents and Afib will not be given coumadin on top of ASA, Plavix, heparin for dialysis and ESRD-induced thrombocytopaty. As well as not drawn platelets panel tomorrow @AM when Plavix and ASA still being in the system. Then the nurse coming to relieve me will not call the doc at midnight because the HD RN is sitting there for an hour pressing the bleeding fistula, and what we're to do right now?

This is my patient, and whatever is going on with him medically is mine, too.

[CosmoRN77]

Yes glad u mentioned core measures..at another facility I worked at was having fall outs due to the physicians..of course they couldn't get the docs to comply so who do they target next.. The nurses...this is what really actually upsets me...

[dishes, BSN, RN]

I get the advocate part of nursing I promise but my point is that we can catch errors all day long but the question is why aren't physicians held responsible for this? And I'll repeat... Yes I know we catch errors and bring it to the physicians attention so why are they not held responsible? If a nurse catches a mistake or an omission why aren't the doc disciplined? The nurse definitely would be in trouble if we miss something.. Just does not seems right to me...

I think part of the problem is your workplace has silo mentality instead of teamwork mentality.

[Pangea Reunited, ASN, RN]

Hello there,

I have been a RN for 15 years now and there is something's that just gets under my skin and would like to know if anyone can relate.. As nurses at the bedside we have tons of responsibility and many tasks which I'm sure u guys are already aware of... Now here is my beef... More frequently I see where the hospital administration is pushing nurses to make sure the doctors are doing their responsibility such as making sure a post MI patient is prescribed a beta locker.. Now I'm all about nursing but I'll be damned if I'm gonna sit there and tell a doctor what he needs to be prescribing to his patients as he is the ultimate one responsible for medication reconciliation and proper medication ordering.. Another example is DVT prophylaxis... They are wanting us to make sure this has been done for patients.. Another no no for me.. I strongly feel this is overstepping our obligations as a nurse.. And I don't want to hear ANYONE mention well a "good nurse" would do this for the physician and patient.. Because I'm a damn good nurse but do not tolerate doing the physicians job.

Hope to hear some feedback!

Thank

I agree with you, although it pains me to agree with anyone who uses "u" as if it were an actual word. I've actually had physicians refuse to order "required" orders and nurse managers tell me that I must call them back and tell them that they have to do it. I don't feel like that's my place. One doctor even said, "Tell administration to write the orders, then. Why does anyone even bother calling me?"

I'm OK with suggesting and reminding, but not enforcing.

[CosmoRN77]

I agree and sorry about the "u".. I'm on a mobile device typing fast and didn't realize I was in English class.. Lighten up!