As an RN on a med surg unit your manager tells you that according to the plan of care for stroke te patient is to get test A, B, C on day 2, and get started on meds A, B. You are to see that the docs either order these tests or write in the progress notes the reason why not. The charts will be audited for compliance by the MD's and if they do not meet standards the RN(s) that cared for the patient will have to account for why not.
I argue that RN's are not responsible for MD's practice, and if there is a problem the docs should be doing their own program and auditing. Sure, if I notice the pt is at immediate risk I will mention it to the MD, and expect a response. I have also gone up the MD chain of command when necessary, but don't think the proposed plan should be left on nursing shoulders, or that nurses should be counselled when the doc does something wrong.
