Nurses knowing more than doctors

I wouldn't say I KNOW more than doctors, as they are much more educated than I am. However, I will say, especially with residants, I am able to see the whole picture clearer sometimes. I have made recommendations and when they don't follow them, if I felt strongly, I have called the attending and went that route. As far as PCP, I have made recommendations regarding cardiac meds or referrals to specialists and they almost always follow my recommendations. I think I am probably up on the most recent cardiac stuff than they are, but no, I would never say I know more than a doc.

Yeah, that's more what I meant. Not knowing in the sense of having more medical knowlege, but having a better intuitive sense of what needs to be done in a given situation.

i have certainly known when a doctor was wrong; whether it was prescribing haldol inappropriately to a pt. or whether it was undermedicating an actively dying pt in pain.

nurses who spend alot of time w/their pts genuinely get to see the big picture of what their needs are.

leslie

I had SVT and 150 PVC's an hour and not one doctor ever asked me how much caffeine I drank per day. I figured it out myself and even though after 24 years I'm still on Verapamil (used to be on Lopressor) my condition was greatly improved when I gave up the caffeine. The cardiologist comments:

"Gee it didn't occur to me to ask you about caffeine."

I had an experience just a couple of weeks ago in HH where I had an order for cleanse wound with H2O2 and apply neosporin to the patients amputation site. I think highly of the doctor but didn't agree with his order. I called him and explained to him that it is now known that H2O2 kills not only the bacteria but also the cells that help to heal the wound. He wanted to stick with the H2O2. Ok, I didn't say anything more. The next day she was back in the hospital with a post-op infection. The doctor called in the infectious doc who promptly changed the order to cleanse with NS and pack with plain packing. Her wound is looking wonderful now. I'll be discharging her tomorrow. You can lead the doctor to water but can't make him drink. Sometimes you can, but not always! Don't be afraid to question or challenge an order.

That exact situation happened to be. At 1 am the doctor told my nurse he wanted me to have a c-section as I had been in labor 35 hours at the time. The nurse and doctor got in a fight in front of me over it and the nurse won. I delivered my son at 2 am and he had to be rescuitated but was fine afterwards. I trusted my nurse as she had been with me throughout most of my labor and I knew she wouldn't let anything happen to me or my child. I was glad to see that she was wiling to stand up for what she thought was best for her patient. I don't think nurses necessarily know more than doctors do but sometimes in the hospital setting we spend more time with the patients and we can better determine their needs. Oh and I was apoligzed to by both parties the next day for them fighting in front of me which I don't remember to well because of the anaethesia.

That exact situation happened to be. At 1 am the doctor told my nurse he wanted me to have a c-section as I had been in labor 35 hours at the time. The nurse and doctor got in a fight in front of me over it and the nurse won. I delivered my son at 2 am and he had to be rescuitated but was fine afterwards. I trusted my nurse as she had been with me throughout most of my labor and I knew she wouldn't let anything happen to me or my child. I was glad to see that she was wiling to stand up for what she thought was best for her patient. I don't think nurses necessarily know more than doctors do but sometimes in the hospital setting we spend more time with the patients and we can better determine their needs. Oh and I was apoligzed to by both parties the next day for them fighting in front of me which I don't remember to well because of the anaethesia.

i guess i am the only one who would rather have a section than have to have my baby resusitated at birth.

just me though.

Many babies need various levels of rescusitation at birth even after a perfect appearing labor and delivery. Just the fact that her labor was 35 hours long could have stressed the baby enough to require this. That baby could have just as likely required the same interventions following a C-section.

I work in a busy ER and we have a large ER residency program but we also have many rotators (MDs from other residency programs). Almost unanimously, they look to the nursing staff for assistance. Not to plan medical care, just general guidelines. If I disagree strongly with an MD, then I do bring it to their attention, privately, of course.

This happened to me today!!! My pt was trying to code on me, sats in the 70's, HR in the 150's, BP 230/120's, etc, and the resident looked at me and said "You have been doing this longer than I have, what should I do?"

I dont think that I know more than the MDs, but I also look at the whole picture of the pt, where the residents I deal with are more on one system. Neuro wont do anything for cardiac, cards wont do anything for ortho etc. Definitely makes my jpb interesting.

The fact that there are multiple disciplines in healthcare is what truly benefits the patients: no one person can have the scope of knowledge and experience to anticipate every scenario. So, yeah, sometimes you DO know more than the doctor!

My feeling (as other posters have put it) is not so much that nurses know 'more', but know 'different'...if we work collaboratively with the doctors, the patients benefit from what we both 'know'.