Possibly Odd Question

psu_213, BSN, RN · Feb 13, 2015

If someone is bleeding, the nurse would know to hold pressure. Suppose the doctor was holding pressure he/she could tell the nurse to "hold pressure" so the doctor can move on to something else.

There are scenarios where the doctor would tell the nurse "how" to do something. For example, suppose the ED doctor is going to reduce a dislocated wrist. The doctor would say to the nurse: "you will provide the counter traction. While pull on the hand, you will hold the forearm down and make sure you prevent movement laterally." (This might not be the exact direction the doc would give you when he/she reduces a wrist, but an example of what you might hear.)

BuckyBadgerRN, ASN, RN · Feb 13, 2015

IF you're working in LTC or acute care. There are many nurses who work side by side, all shift long with Dr.'s. Just saying.

I work at a specialty post-acute hospital that does not have doctors on staff, so the nurses must know what to do when emergent situations occur.
The typical nurse in America perhaps sees physicians for 15 to 20 minutes out of the entire shift, if at all. So, for your aforementioned scenario, the answer would be 'B.' It is not as if we work under the direct supervision of doctors who are always on site.
In addition, what if the doctor doesn't return calls? Nurses need to know how to handle emergent situations, including simple tasks such as applying pressure.

MinneNurse, BSN, RN · Feb 13, 2015

I think if you are considering nursing as a career path, you should do more research about nursing, the future of nursing, and the role of nurses. Your question is really vague and what nursing encompasses is very broad so I'm not sure if your question will generate any useful answers in terms of making a decision. I feel like what you were really trying to ask is if nurses can make critical decisions for the patient or if they are always following direct orders on what to do from a physician. If you spend more time exploring the different aspects of nursing I think you will be better equipped to make a decision for your future. Nursing isn't simple and can't be summed up by answering A or B to your question

windsurfer8, BSN, RN · Feb 14, 2015

I would go to Taco Bell and order a burrito with fire sauce.

Then I would use the fire sauce to cauterize it. Then I would maybe smoke a cigar? I am not sure. Fascinating question bro! I am STUMPED!

KelRN215, BSN, RN · Feb 14, 2015

If a patient is bleeding, I know where to apply pressure. I have eyes.

LadyFree28, BSN, LPN, RN · Feb 14, 2015

Can I ask what would be the rationale to your question?

I ask because your scenario is a pretty basic first aid question; nurses have plenty of critical thinking skills and autonomy to not run to a Doctor to stop the bleeding.

How about ask what we so, or rather, a more direct question, and let's go from there. :)

la_chica_suerte85, BSN, RN · Feb 14, 2015

I think what you're getting at is what kind of autonomy do nurses have -- the autonomy nurses have is guided by their keen critical thinking and assessment skills. Everything a nurse does is guided by a rationale. For example, if, in your example, what the doctor instructs the nurse to do is irrationale due to some other factor the nurse assessed, the nurse will recommend something different to the doctor that is more beneficial to the patient. Really this is more suited to a medication type question. For example, if a nurse looks up the orders to a med that needs to be given for a pediatric pt and the dose looks off, he/she will look up the recommended ranges for pediatrics and call the doctor to have the order changed for the correct dose (yes, this happens).

I'm not sure what you mean by philosophy of nursing. If by critical thinking and assessment skills, then yes, that is the "philosophy" of nursing. Which, I'm interpreting your post to mean simply "nursing practice" itself. I think since you are only "considering" nursing, you might need to learn a lot more than just the answer to your question, in my humble opinion. I didn't know too much about nursing but this wasn't something I considered before going into it. I loved physiology, pathophysiology, helping people, the critical thinking aspects and the independence. You might want to shadow someone because you seem like the type that needs to see for themselves what nursing really is all about.

Nibbles1 · Feb 14, 2015

If they aren't breathing, doesn't matter if they're bleeding. This is basic Google University stuff.

livingthedream77 · Feb 14, 2015

If you are not fully dedicated to nursing, it will be a very difficult and unrewarding profession for you.

Scenario: someone is bleeding. There will probably not be a physician there immediately to tell you to apply pressure. You as a nurse are expected, and within your scope, to see bleeding, and apply the pressure. You should not have to ask where.

Mr. Murse · Feb 14, 2015

This is kind of a funny question, and I'm really curious as to where the OP is coming from with it and what he means exactly.....

Trying to answer the question as best as possible though though.....if you say "in the field" to mean on the job, I kind of laughed imagining myself choosing option "A" and leaving a patient with a critical bleed to go page the doctor and wait for a call back. "Hold on Mr. So-and-so, while I call the doctor and figure out where I need to put pressure to stop that gushing wound of yours. Don't bleed to death on me now! I'll be right back......" Then twiddling my thumbs and catching up on some charting while waiting for a call back, then the doctor's reaction for asking him how to stop a bleed. haha.......

Sorry. It's just funny.

Anyway, to the OP, doctors are VERY rarely around when emergent situations actually happen. Often by the time you actually get a hold of them, the situation has been gotten under control by the nurses.

Editorial Team / Admin · Feb 14, 2015

With th that being said, I have a question on the philosophy of nursing in practical usage.
The scenario is; you are in the field, and someone is cut very badly, the doctor tells you to apply pressure for bleeding. It's a bleed from something vital. Do you, as the nurse:
A: ask the doctor where to apply pressure, and then know where to apply it?
B: have to know where to apply pressure, and apply it?

Your question has absolutely nothing to do with the philosophy of nursing and everything to do with basic first aid. I learned that direct pressure on a wound is what to do back when I took first aid in high school. The only involvement of a physician is when the patient arrives in the ER for definitive treatment. No doctor is going to be in the field telling you to apply pressure. I think you need a better understanding of what the definition of "nursing philosophy" is. Start by understanding that each nurse has a personal nursing philosophy; this is why you will likely be required to write your own statement of nursing philosophy as part of your education should you choose to enter nursing school.

anh06005, MSN, APRN, NP · Feb 14, 2015

This is kind of a funny question, and I'm really curious as to where the OP is coming from with it and what he means exactly.....
Trying to answer the question as best as possible though though.....if you say "in the field" to mean on the job, I kind of laughed imagining myself choosing option "A" and leaving a patient with a critical bleed to go page the doctor and wait for a call back. "Hold on Mr. So-and-so, while I call the doctor and figure out where I need to put pressure to stop that gushing wound of yours. Don't bleed to death on me now! I'll be right back......" Then twiddling my thumbs and catching up on some charting while waiting for a call back, then the doctor's reaction for asking him how to stop a bleed. haha.......
Sorry. It's just funny.
Anyway, to the OP, doctors are VERY rarely around when emergent situations actually happen. Often by the time you actually get a hold of them, the situation has been gotten under control by the nurses.

I also pictured it in an actual field. Outside. Maybe some cows around. Oh my literal mind...

Anyway as PP's have said I'm not sure exactly what you're asking either but nursing isn't like what you see on TV. The docs aren't there when a patient codes. Nurses and respiratory therapists don't wait for a doc when a patient codes. The patient gets bagged, CPR started, medications given, shocked, get labs and ABG's, etc. Nurses can't intubate but they can sure get a patient alive again or work on them until a doc shows up to "officially" give the order. It's up to the nurses to recognize small changes that could indicate a patient is going down. The nurses notice changes in telemetry rhythm and must assess the patient and determine if there is a need to call the doctor, call a code or rapid response, or wait until in the morning.

Again we aren't quite sure what you're asking but chances are a doctor isn't going to be on a hospital floor when something goes wrong and the nurses sure aren't going to wait around for the "all mighty" doctor to tell them what to do.

We are separate professions and all are needed for proper medical care. So your choice in a medical profession should be more based on how hands on you want to be with patients, bodily fluids you can stand, how personable you can be with families you deal with for 12 hours, etc.