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!
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.
it isn't just nurses - there is a social worker who routinely comes up to the nurses' station during rounds and asks the docs questions about her personal stuff. our docs are nice but this drives them crazy and they do remark about it behind her back. of course, they should just say no as they are "feeding the beast".
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.
this is so true - one of our docs really feels blindsided - what he does for someone outside of the office without an exam and chart note puts him at great liability.
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.
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 agree that it is the patient's responsibility to plan ahead and be responsible for their health care.
having said that - i have called a physician while i was in another city where my toddler had another one of his chronic ear infections and got an rx for his antibiotic.
so, i'm not innocent of taking advantage of "professional courtesy".
another bit of truth too - the docs have certain colleagues they would do this for with no problem and then others that they feel not so inclined to help.
i just attended at seminar on "boundaries" . . .the prof started with "i'm not here to chastise anyone as we all are guilty of crossing boundaries. i want to make sure that we can talk about it and feel safe from being treated badly". it was a great class.
but . . . .at the nurses' station during rounds when they are trying to get their work done so they can get to their clinics on time?
*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.
Well, the fact that I've been married for over a decade probably *screams* that I am a sexually active adult ... but, as you said, to each his/her own.
Well, the fact that I've been married for over a decade probably *screams* that I am a sexually active adult ... but, as you said, to each his/her own.
Oh honey, you'd be surprised! The longer I do this the more I realize how sexless a LOT of marriages are!
Specializes in Peds/outpatient FP,derm,allergy/private duty.
. . . .Just FYI...most docs HATE this. I have family members who are Dr's and I work now as an NP with physicians and they really, really hate it when people put them in situations like that. They will act like they are ok with it at the time but then you are totally the subject of their bashing when this issue comes up between them. Trust me. I know there are some really kind docs out there too who are just too nice and don't want to turn anyone away PLUS they don't want to **** you off and potentially alter the professional relationship.
Actually, as I mentioned before, the doctors I worked with LIKED to do this, so don't assume your situation is replicated across the land. I worked with a group of FPs, they weren't tackled in the hallway, and normally wasn't anything more serious than a cold. It appears you don't give others much credit to evaluate what is or isn't appropriate both socially and professionally. Your response has caused all the hostility by using such personal and inflammatory language. This thread in fact is likely heading to topic closed now.
Have a little pride people. You get paid decently. You have insurance. Most of you only work 3 days per week. Go make an appointment!
Really? Not that it's a financial consideration when someone does this, but just a little FYI for you Many nurses in my state are having their wages cut, can't afford insurance, and I work four days a week. If you're thinking about telling me a mere cold could be something very serious and all nurses should have insurance, you needn't bother with that. Just please do not make assumptions about other people's professionalism or social skills.
I will reiterate that not all MD's consider this issue a burden. Certainly, all MD's don't consider their nursing co-workers to be less professional because they (the MD's) provide the occasional opinion or script.
My workplace has a comaraderie that consists of everyone pitching in where/when needed. I have even had MD's ask my nursing opinion for a personal issue.
So, my experience leads me to ask the OP: why does it bother you so much when (a) it truly has nothing to do with you, and (b) generalities are not representative of the issue.
Since when do CRNAs learn to interpret ultrasounds ? And you feel confident about that ?
For starters, what is a CRNA? We don't have them in my country or at least in my state. If it's a nurse giving anaesthesia well it doesn't happen here, we have one anaesthetist per patient in the OR.
Our anaesthetists are doctors and they are fully trained to interpret ultrasounds-regional block anyone?. So I am confident about that. If the lump in my neck didn't go down then yes I would have taken it further and had it biopsied. But the margins of this lump were well defined according to the ultrasound and it was nothing more than an inflamed gland. I wouldn't have worried about it at all but my sister was diagnosed with non hodgkins a few months before and I was stressing over it, the anaesthetist could see how worried I was and offered to have a look at it.
Specializes in Professional Development Specialist.
I have the money and a PCP; I can get my own scripts and illnesses covered properly.
How wonderful for you and your family!
I have seen a total of one person ask a doc in my facility for an opinion. IMHO it was very warranted. The nurse works 6 days a week between 2 jobs to support her kids. She could have made an appointment, but likely that would have cut into her working hours since her doctor isn't open on Sunday. Personally going to the doc would mean time off work. Not so much a problem for me but a HUGE problem for my facility who must somehow cover that time. I know, I just had to work 2am to 6am to cover someone who was sick last night after I worked all day the day before. We don't all have the luxury of a staffing pool and lots of on call staff. Missing time for a simple case of conjunctivis that needs some abx? A waste of time away from caring for that docs patients. On the other hand, none of the docs I work with have any trouble setting limits. If they didn't want to do something, there is no way a simple request from a nurse would make them. At best they would burn a hole in your head with the look of death for just asking. Doctors are not gods, their time isn't so important that they must be respected and cowed to under all circumstances. They are trained longer and better, and I know some really amazing ones, but none are so godlike or frightening that I would feel like someone else shouldn't waste their time by asking a question.
If the Dr doesn't mind and it's saving a sick day for the nurse, well, worse things could happen.
Specializes in Oncology; medical specialty website.
How wonderful for you and your family!
I have seen a total of one person ask a doc in my facility for an opinion. IMHO it was very warranted. The nurse works 6 days a week between 2 jobs to support her kids. She could have made an appointment, but likely that would have cut into her working hours since her doctor isn't open on Sunday. Personally going to the doc would mean time off work. Not so much a problem for me but a HUGE problem for my facility who must somehow cover that time. I know, I just had to work 2am to 6am to cover someone who was sick last night after I worked all day the day before. We don't all have the luxury of a staffing pool and lots of on call staff. Missing time for a simple case of conjunctivis that needs some abx? A waste of time away from caring for that docs patients. On the other hand, none of the docs I work with have any trouble setting limits. If they didn't want to do something, there is no way a simple request from a nurse would make them. At best they would burn a hole in your head with the look of death for just asking. Doctors are not gods, their time isn't so important that they must be respected and cowed to under all circumstances. They are trained longer and better, and I know some really amazing ones, but none are so godlike or frightening that I would feel like someone else shouldn't waste their time by asking a question.
If the Dr doesn't mind and it's saving a sick day for the nurse, well, worse things could happen.
The bottom line is you're (not you personally) asking a doctor to do something that is most likely contrary to his/her licensure regulations.
Thanks for the snide remark, BTW. And I have no family, just myself.
"For starters, what is a CRNA? We don't have them in my country or at least in my state. If it's a nurse giving anaesthesia well it doesn't happen here, we have one anaesthetist per patient in the OR.'
It's pretty much beside the point, but CRNA is Certified Registered Nurse Anesthetist.
For starters, what is a CRNA? We don't have them in my country or at least in my state. If it's a nurse giving anaesthesia well it doesn't happen here, we have one anaesthetist per patient in the OR.
Our anaesthetists are doctors and they are fully trained to interpret ultrasounds-regional block anyone?. So I am confident about that. If the lump in my neck didn't go down then yes I would have taken it further and had it biopsied. But the margins of this lump were well defined according to the ultrasound and it was nothing more than an inflamed gland. I wouldn't have worried about it at all but my sister was diagnosed with non hodgkins a few months before and I was stressing over it, the anaesthetist could see how worried I was and offered to have a look at it.
I guess it is a regional thing? Around here, when someone refers to an "anaesthetist" they are usually referring to a a nurse anesthetist. An anesthesiologist is an MD.
I will reiterate that not all MD's consider this issue a burden. Certainly, all MD's don't consider their nursing co-workers to be less professional because they (the MD's) provide the occasional opinion or script.
My workplace has a comaraderie that consists of everyone pitching in where/when needed. I have even had MD's ask my nursing opinion for a personal issue.
So, my experience leads me to ask the OP: why does it bother you so much when (a) it truly has nothing to do with you, and (b) generalities are not representative of the issue.
I will step outside of the original post and saw that I also know NPs and PAs who seem to enjoy "helping" people who aren't a registered patient of theirs. I seriously don't care how well intentioned the person is....*legally* it is wrong and ethically and personally *my personal opinion* is that it crosses a professional boundary. I know a lot of Dr's and providers who seriously detest being put in this position.
I don't doubt the comraderie of your unit at all and I'm sure it is great! I don't think the OP was as worked up about it as is imagined. I would bet she has been embarrassed by a higher level than normal of nurses making personal requests on the units and I would also bet that some of the requests have been above and beyond the simple stuff.
and I wouldn't want to admit it.
Spidey's mom, ADN, BSN, RN
11,305 Posts
i agree that it is the patient's responsibility to plan ahead and be responsible for their health care.
having said that - i have called a physician while i was in another city where my toddler had another one of his chronic ear infections and got an rx for his antibiotic.
so, i'm not innocent of taking advantage of "professional courtesy".
another bit of truth too - the docs have certain colleagues they would do this for with no problem and then others that they feel not so inclined to help.
i just attended at seminar on "boundaries" . . .the prof started with "i'm not here to chastise anyone as we all are guilty of crossing boundaries. i want to make sure that we can talk about it and feel safe from being treated badly". it was a great class.
but . . . .at the nurses' station during rounds when they are trying to get their work done so they can get to their clinics on time?
steph