tigermonkey

Thank you both for your replies. That helps a bit. Still, it doesn't seem as though acting without orders is covered under the nurse practice act or the "scope of practice" for nurses to give things that are not (at least) ordered prn (Kerrigan...there were not prns for these...all of the prns had already been given and the nurses moved on to giving extra doses). Just makes me a bit unsettled, since the doc could turn around and blame the nurses if things did go poorly after the nurses act autonomously. In a lawsuit, what ground would we have to stand on if we were blamed, considering that the doctor had not provided a prn order, and he had not been contacted to okay the meds/volume? Thanks again.

I'm new to a facility and I love the people there. Fresh hearts and thoracotomies, etc. are quite interesting. It's a great challenge and I'm enjoying it. However, I am concerned that the nurses are telling me that it is the norm to treat symptoms without notifying the MDs. Today alone, extra albumin, bicarb, lasix, calcium, & bolus fluids were given without calling the doc to tell him all of these things being administered. It made me uneasy, as it doesn't seem to be within our scope of practice. I'm told that "you just learn what certain docs want" so they don't have to be bothered, but the bottom line that I consider is the additional training they've (the MDs) received that may give them additional insight into what would treat the low blood pressure (or other issue) that was occuring. Is this the norm in your open heart units? It has not been the norm for me in my past nursing experiences. Anything beyond a tylenol (or in a near-code situation starting some dopamine or whatnot) would be frowned upon if the nurse administered it without an order. Am I over-reacting? I just think about the safety of my license, and as much as I like this place, I don't want to end up being sued because the nurses made a judgement call that would've been better addressed by a doc.