Where did our autonomy go?

[traumamomtx30]

I don't know where we lost the power to do our jobs. Seems like the patients, family, and even the neighbor know more then we do in managements eyes. The medical profession says we've done it to ourselves. I don't know if that's true. I think it is a combination of things but I sure would like to get it back. I know House, E.R., Grey's Anatomy all have interesting situations but; HELLO -they are t.v. shows. We actually had a pt the other night tell a nurse that "doctor's give pca's so nurses don't have to do their jobs". Any response to that? I know there will be some good ones because this is a very bright bunch.

[esra_hms]

hi everyone, I'm new this site:)

can I ask a questıon ??

what, who are the nurses in your country? ıs the nursing a professinal job or a vice health officer?

[cherubhipster]

Pre-nurse here.

What about nurses who have a Masters? A specialty? Doesn't that give them an autonomous egde in their field? A louder voice that can be heard?

Surely someone can say that Nurse Practitioners have autonomy..at least here in NJ they can prescribe meds.

[jessiern, BSN, RN]

I may get bashed for this, but I am grateful that I don't have the autonomy some are wanting. I only have 2 years or education as a nurse, and a year of experience. I thank God there is an individual with more education and experience that can guide me in the care I provide. Perhaps when I have 20 years of experience under my stethoscope I may feel differently, but with the education requirements for nursing, too much autonomy would be dangerous IMO.

[accessqueen]

I find there are two types of nurses. One are the task oriented. They just rush from task to task getting through the day. Of course this type does not feel autonomous. Then there are the nurse that truly become patient advocates, using their skills to make sure the patient gets the best care possible. I feel like I've really accomplished something when I find things that the docs have missed, or not addressed. When I've made enough good calls that the docs go from annoyance to hearing from me to being glad that I've brought their attention to something important. If you want to be that autonomous, be an NP or go for the MD. With autonomy comes more responsibility, more liability.

[sicushells, RN]

I may get bashed for this, but I am grateful that I don't have the autonomy some are wanting. I only have 2 years or education as a nurse, and a year of experience. I thank God there is an individual with more education and experience that can guide me in the care I provide. Perhaps when I have 20 years of experience under my stethoscope I may feel differently, but with the education requirements for nursing, too much autonomy would be dangerous IMO.

I've been a nurse for a little over a year, so I'm with you as far as the level of experience goes... but I don't trust a lot of the residents I work with. Most (not all) of the attendings are good, but they seem to be more interested in getting through rounds so they can go home and be with their kids (and who can blame them?)

So the more educated residents are (often) idiots who just want to get through their month with us. The attendings just want to get the hell home so they can get some sleep and some family time before the on call resident calls them three times through out the night for updates.

And then the nurses are left with the patients.

I find there are two types of nurses. One are the task oriented. They just rush from task to task getting through the day. Of course this type does not feel autonomous...

And then the rest of us try to make sure the patient is getting the best care possible despite the shortcomings. I think that telling the resident with A TON of schooling but little practical knowledge that my patient needs a PCA (because I want to go on my coffee break, lol, just kidding) or that metoprolol might not be the best choice for a pt with high bp but normal hr, and convincing the md to put the order in, is a certain type of autonomy. Granted, it's not the same as putting the order in myself, but really, I'd rather it not be my name on the lawsuit anyway.

So, yes the system is set up for us to have little autonomy, but that doesn't mean we let our patients get subpar care because "the doctor told us to". I think we just have to make sure we use the knowledge and skills that we have to make sure the patients get the best care possible.

And maybe I'm just a little PMS-y...

[cherrybreeze, ADN, RN]

Nurse does not equal autonomous. I don't feel the profession ever has. we as RN's are trained to analyze data then take action, but not necessarily decide which action...that's what MD's are trained to do.

we can make a nursing diagnosis, and then follow pre-set care plans based on our decision.

we collect then analyze data, ,then decide which protocol to follow based on it.

we can hold meds and give extra if values dictate so. ETC...

We are nurses. We choose where we work, in what conditions, which types of pt's and problems we want to fix, what pay we want, we are our clients voices! We are there at 3 am when mr.smith just needs to tell someone he's scared of his surgery and at 330pm when ms.jones just called you back into her room for no other reason than someone to talk to (despite her saying she musta hit that call bell by accident). we may not have the autonomy that is described in the above threads, but darn it all, we do have the ability to independently make everyone's healing process more comfortable, whatever that entails. that's pretty darn awesome and to me, that's more important than having the privilege of picking when i come and go.

Had to comment on this statement...I once had a surgeon bawl me out for holding a blood pressure med on a newly post-op pt who's pressure was something like 90/60, and not calling him to tell him I wasn't going to give it. He said, and I quote, "THERE IS NO SUCH THING AS NURSING JUDGEMENT, YOU WERE PRACTICING MEDICINE."

Nice.