This is a real big pet peeve of mine. This happened to me last week and I wondered if anyone else has been in this situation...
I had a patient who was admitted with diagnosis of GI bleed, low H and H, pending transfusion and GI procedure. The o2 sats were borderline low so I started the patient on 2 liters via NC. I was discussing this patient in the nurses station with my charge nurse when an RT overheard and threatened to "report me". My CN and I both thought he was joking but he said "you need an MD order to start a patient on oxygen!"
Despite our clarification that we did nothing outside of the scope of our practice, he remained adamant. It was a fruitless arguement. NEXT!!!!
PT returned a patient from the gym demanding that a patient be medicated for pain with MS prior to therapy. Patient is sitting in the hall in a wheelchair overhearing this conversation. Patients nurse explains that the patient has a documented allergy to MS and had been premedicated 30 minutes prior. Again a "I'm telling Mom!" threat verbally made to nurse. UGH. NEXT!!!!
It seems to be happening more frequently and I was wondering if there isn't a lack of knowledge on the part of ancillary staff regarding the RN's duties and authority. Just curious...
Also, as a little thing I learned...I try to get parameters for O2 on high risk pts or dependant on condition/medictions/circumstances while I have a doc nearby! :) And I put that on the kardex. That started getting catchy and now, that is a very typical order on the kardex now for titration of O2 on s/sx and pulse ox (I don't rely heavily on Pulse ox alone...s/sx is a direct key!).
If you think of it...try it...it is soooooooo worth it! :) Then no one is confused or feeling like they are risking things if they use O2 per clincal judgement! :) Win Win for all! :)
Good idea.
Even if we are allowed to put O2 on a patient per our protocols, the same as we are allowed to restrain, interevene with a blood glucose of 40, and other nursing intervenes, there's always that caviat "notify the MD".
Again, assuming that you're addressing me, I have no idea what you're saying. I was in no way disrespectful to anyone in my responses.
And I'm just fine at starting my own IVs, thanks.
Have a nice day.
Angie - I agree with you - and I didn't see any disrespect in your answers.
At the hospital where I worked, the RT's were part of the team, and we appreciated their input and suggestions, and generally followed their recommendations - but they had mostly ONE focus, and ours was an all around focus for total care. They were NOT in any way superior - and an attitude like that would get them nowhere.
As for PT, if we got a good one, they would call and tell us when they would be there and ask that we medicate them for pain ahead of time. But they didn't suggest a particular med.
Tweety, BSN, RN
36,295 Posts
Good idea.
Even if we are allowed to put O2 on a patient per our protocols, the same as we are allowed to restrain, interevene with a blood glucose of 40, and other nursing intervenes, there's always that caviat "notify the MD".