(+) skin testing - Doctor still wants you to Administer med, will you do it?

[AnnaSL, BSN, RN]

My friend is a nurse assigned at ER and the Doctor asked her to do a skintest for a specific medication. After 30 minutes the result shown POSITIVE.. My friend inform the Doctor regarding result and the Doctor told him, despite the (+) skintest, to administer the drug.. My friend refused to do what the doctor told him and told the doctor that if he wants to administer the said drug, (i dont quite know if it was an anti-infective or something else) he should do it himself...

The Doctor, got mad and a day after that, He informed the administration that as long as the Nurse (my friend) is still there, he will not do his decking/duty in ER...

for me, my friend did the right thing...

[RNsRWe, ASN, RN]

I just love MDs who throw tantrums like three year olds, don't you?

"I'm not gonna play in the sandbox if SHE'S there...."

Sheesh. Yes, your friend did the right thing as she knew it was inappropriate to administer the drug (why bother with the skin test if it was entirely irrelevant?). The doc was probably mad because (1) she was 'defying' him and (2) he would have to be totally responsible for the outcome of this decision--and he would have greatly preferred SHE be responsible as he would likely deny all knowledge of why she administered the drug.

If the hospital has any balls whatsoever, they will inform him that he WILL do his duties there, or be held responsible for refusing.

Deal with it, pal.

[Tweety, BSN, RN]

She did the right thing.

Nurses are not to administer medications or treatments they are uncomfortable with. We don't blindly follow doctors orders.

Perhaps however, sometimes the benefits outweight the risks and it's medically necessary. This is a rare scenerio however. I would have asked the pharmacist for some alternatives or if some pre-meds such as benadryl or steriods might help, discussed the risk with the pharmacist and the MD, definitely would have informed the patient that despite the reaction the MD wants them to recieve the medication, made the doctor give informed consent to the patient, covered myself, informed the manager, informed risk management, etc. and refused until all bases were covered.

Probably by then I'd be labeled a trouble maker.

[RNsRWe, ASN, RN]

....

Probably by then I'd be labeled a trouble maker.

LOL, me too!

[Agnus]

I am working under my license not the physician's. Ifthe concern here is about the nurse loosing her/his job well my feeling about it is this.

I was looking for a job when I found this one. I can always find another. A particular job is not more important than my license. Without that license as a nurse I am up a creek.

With that said It is unlikely your friend job would even come in question over this issue.

[pagandeva2000, LPN]

At least this idiot could have written an order by saying to administer in spite of allergy and observe for certain symptoms, IF the ends justify the risk. Goodness...then send good ole doc home if he doesn't want to 'play in the sandbox'. Jerk...

[iluvivt, BSN, RN]

If the manufacturer of the drug recommends a test dose and the test dose indicates a hypersensitivity reaction the nurse was correct in refusing to give the drug. I would have called the pharmacist and had him to talk to the MD about alternative selections. On occasion I have seen a medication given despite a pt sensitivity to it when the benefit outweighs the risk. In these case the pt usually gets a pre-med of benadryl a steroid and even some Tylenol. In addition,there must be a note made in the medical record by the MD about the reason why this is the only med that will work in this instance. PS....MD is not a team player and his behavior should be reported