nurses VS doctors

**canoehead, BSN, RN** · Sep 19, 2011

Without knowing the situation...it's wise to run the situation by your charge before you challenge a physician's judgement. You can also approach the doc saying "I don't understand your rationale...." they often know exactly what they're doing and you'll learn from them.

xtxrn, ASN, RN · Sep 19, 2011

hello guys just wanted to vent out and hear your opinions as well.. so a doctor at work prescribed a med that what I think based on my judgement and what I have learned from school is not right for the patient.. so I called the doctor told that doctor the condition of the patient and asked if she would still want us to give the patient the medication.. she got all mad and started to use words like "who is the doctor here!?!" she imediatley called the admin whose buddy buddy with her told her I don't know what because the next thing I know that that mean lady who has nothing to do with nursing btw just showed up in the station all mad saying that the doctor called her and that we have no right to question any orders that the doctors make... No matter what it is.. I so not agree with that.. because I am a patient's advocate and I will do what is best for my patient.. the doctor never spoke with the head boss of the nurses she went and ranted on to that admin lady who keeps on poking her nose to places where it doesn't belong.. she doesn't know crap that's all I have to say..

And you do WHAT in healthcare?

iamann · Sep 19, 2011

I'm a nurse the doctor was giving a psych med to a pregnant girl that can cause serious damage to the baby I consulted with the charge nurse and pharmacy about it before I called the md and they all agreed that we news to ask the doctor about it coz she dis that too before and when she was asked by another nurse about it she immediately d/cd it..

iamann · Sep 19, 2011

need not news typo error

MamaCJRN · Sep 19, 2011

Sorry this happened to you, I have had docs go over my head so much I have a permanent part in my hair :)

sweetnurse63, BSN, RN · Sep 19, 2011

Well doctors are human just like we are and can make mistakes. Their licenses are not the only ones on the line and it is about patient safety. As nurses, although most of the time we trust their judgements, we have a right to question an order if it is not clear as to why we are giving it. :idea:

Pepper The Cat, BSN, RN · Sep 19, 2011

Sometimes it is not what you are asking the doctor, but how.

Maybe if you had said "I just want to clarify that ordered xx drug for Ms A as she is pregnant?"

As for the "mean lady" in admin - just because someone isn't a nurse doesn't mean that they don't play an important role in the running and functioning of the hospital.

David13, MSN, RN · Sep 19, 2011

You are absolutely doing your job when you question an order that you believe may harm the patient. Being a patient advocate is one of the primary roles of a nurse.

For your administration to say that a physician's order should never be questioned is wrong is so many ways. Nurses are not there simply to carry out orders. Not to mention, if we carry out an order that harms the patient, we are liable as well as the physician.

Is that administrator going to be able to give you back your license if you lose it? Always do what is in your patient's best interest.

Trauma Columnist · Sep 20, 2011

Agree that you should feel free to question orders.

On the other hand, much is in how the request is phrased - above posters have some good ideas.

canesdukegirl, BSN, RN · Sep 20, 2011

From the verbiage of your post, I gather that you are quite angry.

Here is the way I would have handled the situation:

"Hey Dr. S. I see that you have written for Ms. P to have XYZ drug. When I was looking this drug up prior to administration, I found the notes for this particular drug state that pregnant patients should not take this. I called the pharmacist prior to calling you, and he also recommended that this drug not be administered to this pt. What would you like to use as an alternative?"

This serves three purposes-one, that you are showing initiative in protecting your pt by looking up the drug. Two, you called the pharmacist to verify your findings and have relayed this information to the doc. Three, since you have offered this factual information to the prescribing doc, you have allowed them a "way out" of a potentially harmful situation by using the question 'what would you like to use as an alternative'.

Phrasing your communication like this eliminates any challenge from your question. Rather, you are coming across as a true multi-disciplinary team member in providing the best care possible for your pt.

On a side note, I understand that administrators are not always present. However, most of them understand basic nursing principles. I caution you to be more patient in this regard and not immediately label this person as "that mean lady", because bridges are difficult to rebuild.

Continue to be a pt advocate, and always question orders that you find inappropriate. You did the right thing by protecting your pt.

ErinS, BSN, RN · Sep 20, 2011

We absolutely can and should question orders. I have had situations where pt's would have DIED if I had just followed orders. I think there is a way to do it that is professional. I would always encourage you to use pharmacists- they are such a great resource that is underutilized by nurses.