What would you call "Practicing Medicine"

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Hello everyone.

Just a curious thought for the day. What examples for a nurse "Practicing Medicine" can you give.:nono:

Ex: Giving meds without a MD order.

Changing med dosage without MD order.

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Giving medical advice to your neighbors that does not include "See your doctor".

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Specializes in A myriad of specialties.

Here's an example of 'practicing medicine' that I've seen a lot of over the years. Nurses being so comfortable with the MDs that they write orders with the assumption:"Oh Dr. X will approve that--it's ok". It's NEVER ok to write an MD order with that kind of assumption.

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Specializes in NICU, Infection Control.

Look up "scope of practice" on the BON site of your state. Anything not included is beyond your scope of practice.

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Specializes in Med/Surg; Psych; Tele.

I had a guy who was getting ready to be discharged to a NH/rehab (in an hour or so) and he had developed some kind of pain. So I called the doc and got an order for Morphine IV X 1 dose. Turns out, my tech had already d/ced his INT because we knew he would be leaving. Well, I was not about to call this doc back to ask him if I could change it to SC. So I gave it SC. Ooh, I'm so bad!

I had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

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I had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

IMO, "Daily" doesn't mean at 0800 or 0900 or whatever random time that pharmacy deems to be what they'll put on the MAR for "daily" meds. So as long as you weren't giving it 2x a day or something like that, just daily, I don't think it matters what time you give them, as long as it's "daily." And if it worked at the hospital, telling him that's what you did and worked well and he should probably do at home, well, I don't see a problem.

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I had a guy who was getting ready to be discharged to a NH/rehab (in an hour or so) and he had developed some kind of pain. So I called the doc and got an order for Morphine IV X 1 dose. Turns out, my tech had already d/ced his INT because we knew he would be leaving. Well, I was not about to call this doc back to ask him if I could change it to SC. So I gave it SC. Ooh, I'm so bad!

I understand your frustration but you know you weren't supposed to do that and you should not be posting it here in public.

I had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

I see no problem with this.
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Nurses may not diagnose or prescribe. We are to observe and report departures from normal.

I know it's unrealistic and old-fashioned and paternalistic and frustrating but that's the law. And unless you are going to medical school, learn it and obey. That's how you keep your license and your good name and your income.

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Specializes in Community Health, Med-Surg, Home Health.
Giving medical advice to your neighbors that does not include "See your doctor".

I try my best to avoid giving too much medical advice at all, because once a person sees a nurse advise something, they take it to heart. This, to me, may lead to being summoned to court if something adverse happens to the client. I had one friend that is selling Zoni (I think that is the name) products and asked me to be a seller under her. I told her that for one, I really don't advocate for herbal remedies without physician supervision and also, that I don't know enough about it from reliable sources to advocate for it's use. These people may be also taking prescribed medications in addition to this product that may be contraindicated, and my advocacy may add to their complications.

Once, during a home care visit, a mother asked me of a good antihistamine for her daughter to take. Again, I told her it was best to ask her pediatrician. I told her that I felt comfortable speaking of what was already prescribed, but would never suggest. I have only been an LPN for one year, and do not have enough experience to suggest things.

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Specializes in icu, er, transplant, case management, ps.

If you are not an N.P., passing, drawing, giving, cutting, sticking anything into anyone.

Woody:balloons:

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Specializes in Trauma ICU, MICU/SICU.
If you are not an N.P., passing, drawing, giving, cutting, sticking anything into anyone.

Woody:balloons:

Huh? I'm an RN and I...

Pass foleys, draw labs, give meds, cut (o.k. I don't cut my patients), stick needles (but not chest tubes LOL) into my patients. :lol2:

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How about giving a fleet's enema that the doc ordered (after he was called asking for this order) -- having no success and deciding to go ahead with a soapsuds enema without an order?

Oh and manual disimpaction after the soapsuds...

Then a mineral oil fleet's for good luck...

Is that practicing medicine???

I'm seriously asking.....

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