Just my rant, opinion. I hate it when co-workers ask doctors for medical advice or even to write prescriptions for them!!!! This is while both are at work at the hospital.
A nurse will stop a doctor at the nurses station or in the hallway and ask for a prescription for such and such or ask about that pain in their foot that has been going on for several weeks, or whatever!!!! I cringe and start grinding my teeth.
I've never heard this response but I wish the doctor would say. "Sure, take off all your clothes so I can do a physical assessment and I will be glad to assess your condition or write that prescription!"
Nothing I can do about it, just letting off steam here!
First of all, I think everyone's time is important (not just dr.'s) and there is a time and place for this behavior. If you had witnessed coworkers asking for inappropriate care (can you put a cast on for free for me please?) or at an obviously inappropriate time, then the extent of your rant would be justified.
However, you may want to ask yourself why it bothers you so much. What is the real underlying cause of annoyance? I think it is interesting to note to yourself that you, too have asked for a bit of advice and medical reassurance. The personal experience that you had should enable you to relate to your coworkers. What is holding you back from accepting that you are no different from them? That their needs are just as important as yours were?
Perhaps this is all just because you have a bit of guilt for 'bothering' a physician. You don't need to feel bad for asking a perfectly acceptable question. You are human too. You were just feeling a great deal of stress over your eye and chose the right resource. In fact, the physician probably felt good over the fact that their knowledge of your situation was able to provide you the comfort that you needed. I know that I feel good when I am able to comfort our patients and families when they lack medical knowledge, I'm sure you do too!
Wee one, yes I think the whole psychological part of this is I hate to ask for help. I am very independent. A quick, look at this, should I see my PCP. Or a casual chat in the break room, along the lines of, "this is what my PCP thinks, what do you think," is fine.
However I still see it as a doctor in a hospital, working, taking care of x number of patients, fretting that his office is calling him "where are you the waiting room is full." Thinking why is patient A's potassium still out of whack, or even, I hope I get home in time to see Johny's soft ball game, and nurse Suzie stops him for, will you write me a prescription for such and such!!!
Also I honestly think many of the examples were bad medical practice. A CRNA interpreting ultrasounds. What is going to happen to perks, professional courtesy, and friendship if this lump turns out to be cancer????? Refilling metoprolol, yikes, I mean this is blood pressure medication we are talking about!! A person taking blood pressure medicine should be seen by their PCP to have their BP checked, not just be refilling it willy nilly. I've heard that hypertension can lead to strokes and heart attacks!!! But that is ok, just stop a friendly doctor in the hallway and keep getting your prescription refilled without getting checked by your PCP.
I guess carrachael 2 and I will agree and ain't no one going to convince me otherwise.
And exactly how does it discredit the nursing profession? Such strong words. Does an RX refill always require an assessment, history, review of symptoms? If your md asks you to drop your drawers just to refill your Metoprolol for another month, well... I'd be looking for another doctor.
I would never ask someone to drop their drawers for a Metoprolol refill but the fact that you think it is appropriate to ask a Dr. for this while he is working in the unit is both appalling and ignorant. I do Metoprolol refills *all the time* and I like to personally take the person's BP, assess for any episodes of hypotension, listen to heart tones and do a quick mental/psych review since there are some real side effects of these meds.
And I know a LOT of Dr's, my family is packed with providers and you should know that table talk with the fam is full of stories of nurses like you who approach them for Rx's for everything from strep throat to to lady partsl discharge.
A CRNA interpreting ultrasounds. What is going to happen to perks, professional courtesy, and friendship if this lump turns out to be cancer????? Refilling metoprolol, yikes, I mean this is blood pressure medication we are talking about!! A person taking blood pressure medicine should be seen by their PCP to have their BP checked, not just be refilling it willy nilly. I've heard that hypertension can lead to strokes and heart attacks!!! But that is ok, just stop a friendly doctor in the hallway and keep getting your prescription refilled without getting checked by your PCP.
I understand why it bothers you. You aren't saying it just freaks you out and rocks your world and ruins your day and you lose sleep over it or anything. You are saying it is embarrassing and I agree. I think nurses should have some professional PRIDE and go to their own GP and pay the $$. To me it is like begging for freebies and personally, I have too much pride for that. But I guess if you don't have personal pride and you don't mind spilling your personal health information to colleagues and you don't have boundaries, then I can see why you see it as no big deal.
In light of other things that happen on a unit, it truly is not a big deal. But as far as nursing professionalism, it is just one more thing that quietly digs away at the level of professionalism we've worked hard to achieve.
Meh, I think it depends on context. I had a UTI (got a free u/a by a friend in the lab, lol) , asked doc for macrobid, he happily helped me out. If I had something chronic or complicated and I asked to be treated on the sly, or asked for sched IIs, thats a different story. In the end, the liability is the prescribers and it is up to them to set limits for what they are uncomfortable with. One of our docs just refuses, b/c his insurance doesn't cover him for these informal consults. Other docs are in the same situation but are willing to risk it. Their license, their liability, their decision. I'd completely understand if they didn't wan to do it, but it is up to them to say so. It is a professional courtesy, but certainly not an expectation. I'd happily take their BP if they asked me to, lol.
Specializes in acute care med/surg, LTC, orthopedics.
I would never ask someone to drop their drawers for a Metoprolol refill but the fact that you think it is appropriate to ask a Dr. for this while he is working in the unit is both appalling and ignorant.
I’m figuring by your posts you mustn’t be too cognizant of the ways of the world. If you call in an Rx refill at the pharm such as a regular bp med, but you’re out of refills, pharm is not going to say “sorry, you have to go in and see your GP to get a new Rx, meanwhile stop taking your meds” fully realizing it may take days or weeks to get an appointment. They put a call/fax into your md, get approval for a couple months of refills to tide you over until the md is seen. It's no different. You'd think the nurse was requesting a craniotomy by your reaction.
But what's appalling and ignorant is those people who are so hot and bothered by something that doesn't even involve them one iota!
I do Metoprolol refills *all the time* and I like to personally take the person's BP, assess for any episodes of hypotension, listen to heart tones and do a quick mental/psych review since there are some real side effects of these meds.
What do you mean YOU do Metoprolol refills all the time, assess for hypotension etc... are you a doctor, or a nurse working completely out of her scope of practice??
And I know a LOT of Dr's, my family is packed with providers and you should know that table talk with the fam is full of stories of nurses like you who approach them for Rx's for everything from strep throat to to lady partsl discharge.
Oh boy. There's a LOT of docs in your family, well.... I guess that certainly qualifies you as having intimate knowledge that "MOST docs hate this." (your words) Way to be amateurish.
Specializes in LTC, home health, critical care, pulmonary nursing.
This is VERY different. She knows your history and has seen you personally many times. She knows what your heart sounds like, she knwos your personal and family history, etc. Most RNs who stop a Dr. in the unit do not actually see that Dr. as their own healthcare provider.
True. I can't imagine asking one of the other docs anything. Except maybe if I had a gnarly skin lesion, and that would be purely for the sake of grossing them out.
I’m figuring by your posts you mustn’t be too cognizant of the ways of the world. If you call in an Rx refill at the pharm such as a regular bp med, but you’re out of refills, pharm is not going to say “sorry, you have to go in and see your GP to get a new Rx, meanwhile stop taking your meds” fully realizing it may take days or weeks to get an appointment. They put a call/fax into your md, get approval for a couple months of refills to tide you over until the md is seen. It's no different. You'd think the nurse was requesting a craniotomy by your reaction.
But what's appalling and ignorant is those people who are so hot and bothered by something that doesn't even involve them one iota!
What do you mean YOU do Metoprolol refills all the time, assess for hypotension etc... are you a doctor, or a nurse working completely out of her scope of practice??
Oh boy. There's a LOT of docs in your family, well.... I guess that certainly qualifies you as having intimate knowledge that "MOST docs hate this." (your words) Way to be amateurish.
I am in NP. I would never work outside my scope of practice. I really hate that the discussion turned bitter with you calling me "amateurish." I don't think the original poster said she was all "hot and bothered" but I need to go back and read the post. From what I read it sounded more like she was embarrassed. I should change my wording to " a LOT of providers I know" profess to really hating this. We have at least three in our family and I've shared dinner and holidays with more than I can count and yes, I've heard the discussions. They appreciate their nurse colleagues but most don't like being put in the position of prescribing for nurses while making rounds.
The liability in doing this is huge. People think that a "little strep throat" or a little "pink eye" is all easy peasy and no big deal but then there are the cases of pharyngitis that turn out to be way more serious than the patient believes or the "pink eye" that turns out to be a detached retina or HSV in the eye....and both the provider and the person asking for a prescription without a thorough assessment are putting themselves at risk. It is a professional infringement but I guess, as you said, the Dr's *can* say no although it is an awkard situation.
Also, you should know that a lot of state medical boards are cracking down on prescriptions provided for people that are not established patients in their practice. A colleague of a physician I know almost lost his license for prescribing Amoxicillin to his sons soccer teammate for an ear infection . In order to legally prescribe for you, you MUST have a chart established at the Dr's primary office OR you must do so within a certain time period (states vary on their laws for this). I predict that fewwer and fewer docs will do this.Of course, I DO totally recognize that it is up to the physician to recognize the constraints on prescribing practices and to say no but a lot of the ones who will do it are actually very respective and dependent on good nurses taking care of their patients and they do not want to offend anyone.
I just have personal boundaries. I really don't need Dr's I work with to know I am not feeling well, have a bad knee, a little eye drainage or whatever. The ones I have worked closely with don't bring their personal problems to the work day and I feel I should not either.
And I am actually VERY cognizant of how the refill system works thank you very much. I would NEVER jeapordize my license by calling in a refill for even my BEST FRIEND just to tide her over unless she is an established patient in our office...and even then I would be very hesitant about doing so unless I saw her in the office. Every Dr's office I know will give you at least a months refill on a med before requiring you to come in for a refill. HOWEVER, a LOT of patients abuse this and will get the 1 month refill, fail to come in and then they want the refill again. They think it is just so we can charge for an office when in reality there are some very valid safety mechanisms in place for refilling certain meds. Every.single.day we have patients who want "just one more month" and they've been doing it for months. There is no excuse really and any provider who would call in a refill for a patient they do not personally know is REALLY putting their license at risk.
pharm is not going to say “sorry, you have to go in and see your GP to get a new Rx, meanwhile stop taking your meds” fully realizing it may take days or weeks to get an appointment.
It is the patients responsibility to plan ahead and be responsible for their healthcare. A pharmacy will usually give you X amount of pills to tide you over OR your doctors office will give you at least a month (or at least that is how the ones I know work) which gives you plenty of time to come in for an appointment. I have meds that I must take on a daily basis and when I see the refill number get down to "1" I make a call and start planning ahead instead of waiting until I have just 3 left.
I don't like it when docs are asked things on the fly either. But I'm not involved so I move on with my work. Of course, that doesn't stop me from coming to allnurses and having an opinion about it.
Most of the time those requests interrupt the work being done for actual patients on the unit.
Like most things in life ... context is everything. Asking about some pretty straightforward symptom on a non-embarassing body part is within comfortable boundaries for many coworkers who work together day in and day out, and really does not interrrupt the work day.
As in ... "I've had burning with urination for 2 days, and here's my POC UA showing WBCs in my urine" or "I've got sinus pain and am blowing green stuff out of my nose" ... in my personal experience these are common, brief conversations for which the docs that I've worked with are happy to write for an antibiotic. They have the expectation that we know to mention any other symptoms which would indicate the need for further evaluation, and to follow up with our own providers if that first-line course of treatment is not successful or other problems develop.
Additionally, the last 2 times I have seen my own PCP, he has asked me, "So what are you thinking this is?" and "Do you feel like you need a CXR?" We have that level of comfort with each other's knowledge. If we did not, then I would certainly expect a more by-the-book assessment from a provider who was less familiar with me.
Specializes in Oncology; medical specialty website.
As was previously mentioned, docs could be in violation of their license for just writing a script if they do not have a chart on you. If they wrote a prescription and you had an adverse reaction to the med, they would have no leg to stand on. It is pretty much a requirement of their license to have at least some documentation of an exam. I wouldn't want to put someone in the position of violating the requirements of his/her license, even if they would be sympathetic enough to oblige me. I have the money and a PCP; I can get my own scripts and illnesses covered properly.
Like most things in life ... context is everything. Asking about some pretty straightforward symptom on a non-embarassing body part is within comfortable boundaries for many coworkers who work together day in and day out, and really does not interrrupt the work day.
As in ... "I've had burning with urination for 2 days, and here's my POC UA showing WBCs in my urine" or "I've got sinus pain and am blowing green stuff out of my nose" ... in my personal experience these are common, brief conversations for which the docs that I've worked with are happy to write for an antibiotic. They have the expectation that we know to mention any other symptoms which would indicate the need for further evaluation, and to follow up with our own providers if that first-line course of treatment is not successful or other problems develop.
Additionally, the last 2 times I have seen my own PCP, he has asked me, "So what are you thinking this is?" and "Do you feel like you need a CXR?" We have that level of comfort with each other's knowledge. If we did not, then I would certainly expect a more by-the-book assessment from a provider who was less familiar with me.
I agree about the context. *Personally* I would have never stopped any doc in the hospital and asked about a UTI but what the heck, I can get that others don't care. For me, it just *screams* "I had sex a few days and didn't get up to wipe and then worked a 12 hr shift without drinking water." and I wouldn't want to admit it. The Dr or provider is still, IMO, ignoring standards of care and licensure regulations by doing this. Just last week I had what seemed to be like an easy UTI but turned out to be a renal calculi with hydronephrosis. The patient had no clue, just had some burning UNTIL I cranked on her flank to illicit CVAT .
What it all boils down to is this: Dr's shouldn't do it and they should have the guts to say no but in a manner which is not hostile. Nurses should, for the most part, respect that it puts the Dr. in awkward position and finally, the excuse that a nurse "doesn't have the time" to make a Dr's appointment puts them in the category of all the patients we ourselves complain about!
. In order to legally prescribe for you, you MUST have a chart established at the Dr's primary office OR you must do so within a certain time period (states vary on their laws for this). I predict that fewwer and fewer docs will do this.Of course, I DO totally recognize that it is up to the physician to recognize the constraints on prescribing practices and to say no but a lot of the ones who will do it are actually very respective and dependent on good nurses taking care of their patients and they do not want to offend anyone. 
and I wouldn't want to admit it. The Dr or provider is still, IMO, ignoring standards of care and licensure regulations by doing this. Just last week I had what seemed to be like an easy UTI but turned out to be a renal calculi with hydronephrosis. The patient had no clue, just had some burning UNTIL I cranked on her flank to illicit CVAT
wee_oneRN
120 Posts
First of all, I think everyone's time is important (not just dr.'s) and there is a time and place for this behavior. If you had witnessed coworkers asking for inappropriate care (can you put a cast on for free for me please?) or at an obviously inappropriate time, then the extent of your rant would be justified.
However, you may want to ask yourself why it bothers you so much. What is the real underlying cause of annoyance? I think it is interesting to note to yourself that you, too have asked for a bit of advice and medical reassurance. The personal experience that you had should enable you to relate to your coworkers. What is holding you back from accepting that you are no different from them? That their needs are just as important as yours were?
Perhaps this is all just because you have a bit of guilt for 'bothering' a physician. You don't need to feel bad for asking a perfectly acceptable question. You are human too. You were just feeling a great deal of stress over your eye and chose the right resource. In fact, the physician probably felt good over the fact that their knowledge of your situation was able to provide you the comfort that you needed. I know that I feel good when I am able to comfort our patients and families when they lack medical knowledge, I'm sure you do too!