Nurses needing??? doctor's orders to administer medications

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Nurses needing doctor's orders to administer medications. What really is the rationale behind this? Nurses know their drug study very well yet we still have to wait for the doctor's order. What knowledge of medications do doctors hold that nurses do not?

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I believe that a doctor's order for a medication is strongly needed for LEGAL purposes and apart from that he/she must also write this in the Physician's Notes of the patient's chart justifying that he/she called for this med to be administered. They PRESCRIBE the medications - its dosage, how much the patient should take and how frequent it must be, not us nurses. The knowledge that we have about therapeutic levels of drugs are really useful, especially when we read back to them their orders (in that way, when we notice an error, we can politely tell them that there is a mistake on the dose of the med, etc.) before we carry them out. However, if the doctor ordered a medication and you as a nurse believe that it's wrong, you can always tell the nurse supervisor/unit manager/senior nurse in your ward regarding the situation.:D

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I believe that a doctor's order for a medication is strongly needed for LEGAL purposes and apart from that he/she must also write this in the Physician's Notes of the patient's chart justifying that he/she called for this med to be administered. They PRESCRIBE the medications - its dosage, how much the patient should take and how frequent it must be, not us nurses. The knowledge that we have about therapeutic levels of drugs are really useful, especially when we read back to them their orders (in that way, when we notice an error, we can politely tell them that there is a mistake on the dose of the med, etc.) before we carry them out. However, if the doctor ordered a medication and you as a nurse believe that it's wrong, you can always tell the nurse supervisor/unit manager/senior nurse in your ward regarding the situation.:D

hi! thank you for your reply. so nurses needing doctor's order for medication administration is implemented only because it's the law?

do you think that the knowledge of doctors and nurses regarding drugs are the equal? i think so. IF ever i'm correct, if both parties have equal knowledge of drugs, i think the law should be changed

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Specializes in Critical Care.

@amphetamine

May I ask how long is your work experience?

Honestly speaking, not to degrade the profession of nurses, we have a lack of knowledge about medications. FYI i am a nurse too. Have you encountered the medicine PRadaxa? It was my first time to encounter that drug after 3 yrs of working in a tertiary hospital. It is a new drug as replacement for coumadin. As a nurse, if you look it in a drug handbook, you wont be able to see that yet. What about fluimucil? you'll think why is the doctor giving a cough medication to a px without cough? So I asked the doctor it is a prophylaxis for the kidneys especially before CT scan with contrast. Doctors are exposed to new infos about medication. Yes we know the correct dosage of medications we usually are expose but what about the new once? The tapering and the shifting of new meds to the other. I took pharma before but honestly speaking, I can't memorize all the medicine unless I am exposed to it. As a legal matter, that is their job to prescribe and for us to administer. But that doesn't mean if they prescribe it we have just have to give it no matter what. We still use our knowledge on pharmacology and think if it is the right dosage and right medicine. I don't know what you have against MD's but as for me, working with them is a good experience especially when they teach you new stuff.

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Specializes in Acute Care. ER. Aged Care/LTC. Psyche.

let's put it this way,

doctors will diagnose a patient, will take an in-depth look on what is going on, analyze lab values and x-rays, then order some treatments and medications based on their very deep understanding on certain medications.

basically, that's the usual process. Given that, from the very start of the process, we CAN'T diagnose a patient because our scope of practice and our training does not allow us to. How can you order medications if you have no diagnosis?

It's all about training, scope of practice, and SAFETY. We maybe knowledgeable, but it may not be enough.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
do you think that the knowledge of doctors and nurses regarding drugs are the equal? i think so. IF ever i'm correct, if both parties have equal knowledge of drugs, i think the law should be changed

The amount of training we, nurses, get compared to what physicians get about pharmacology and therapeutics is definitely not equal. Knowing how medicines work requires a deeper understanding of basic medical sciences such as human physiology and biochemistry. Physicians train in basic medical sciences for the first 2 years of med school and they also have the same science courses at the undergraduate level while in pre-med. Nurses have a few courses in basic medical sciences and an abridged version of pharmacology.

The reason for this discrepancy is scope of practice as others have stated. Just think about it, pharmacists go through an extensive program of learning how drugs work, they are the experts in this field but they do not prescribe medicines. That's because they lack the training in physical examination and diagnostic reasoning that physicians have. They know drugs but their scope does not involve the ability to examine a patient and determine what their diagnosis is.

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