Aren't we glad that diagnosis comes from the physician? We had a patient several years ago who presented with the same s/s- SOB, chest pain, anxiety, tachypnea, etc. No one could find the physician, and the nurses who eventually coded the patient felt the patient had a PE. The doctor made fun of them later in front of the family since they didn't recognize that the patient was in pulmonary edema. I told him I didn't care if it were a PE, pulmonary edema or a chicken bone in the throat. The patient was in distress, the nurses appropriately treated the symptoms and successfully resuscitated the patient. Diagnosis and treatment is a physician responsibility. Recognition of symptoms, physician notification and treatment within our scope is our responsibility. Our physician did back down and apologize to the nurses and the family members for his thoughtless statements. Your actions were very appropriate, and I agree with everyone that documentation is always something we have to take time for. In reference to the critical values, it is our hospital policy that only a licensed staff member may accept critical values, C&S results or orders over the phone. Unlicensed staff as a general rule do not have the education to recognize the importance of the information given, and they don't have the rest of the picture on the patient. It sounds like this person may just like to be in the spotlight. I may be wrong, but she needs to function within her scope. It will protect her, too.