Hello! I know I'm a little late to the party, but I want to tell you firstly, do not be disheartened or discouraged. As nurses, PAs, NPs, Docs, we are all on the same team! I read through all of the previous responses and bits and pieces of each rang strong in my mind as being ways our processes could improve. I'm gonna take the lazy route and just list what I think would be beneficial for all :) Please keep in mind that I am coming from an ED where the PAs and NPs usually provide care in our "Fast Track" area and see mostly 4s and the occasional 3.
1. Entering all of your diagnostic and med orders up front makes the nurses' time management easier. If your facility allows, entering med PRN orders could save you and your nurses time and energy. For example, order the ibuprofen, then put the lido patch and Tramadol in as PRN. The nurses on your team should be reassessing the pts after pain meds are given anyway, so it is not a must that they be reassessed by you as well. This can serve multiple functions: it saves you time, and shows your nurses that you trust their nursing judgements, and promotes a team/collaborative care atmosphere. You can always say, "hey Sue, I'm gonna throw in orders for pain meds for room 29, let's just start with the Ibuprofen and if she needs more the orders are there."
2. If possible, order PO meds. Unless you have a reason not to.
3. As for over-doing the workup, as a nurse I personally feel that if it makes sense, you should order it. Nurses usually only go batty when we see a urine ordered for a foot lac or an abdominal CT with oral contrast and an IV for a kid who presents with abdominal pain x2 hrs (after eating fried Oreos), no home meds given, and is jumping around and sneaking Cheetos from moms purse.
4. I don't think it's at all necessary to be overly friendly with the nurses you work with, but I do believe if you help foster a team approach, everyone will have greater satisfaction. I personally love the providers who talk to me about what they are 'thinking' about a patient (when time allows of course) and allow me to be more than just a 'task completer'. It feels so much more colaborative AND it makes me feel more comfortable to ask for education from the provider.
Just My Humble Opinions :)