Fine lines between MD & RN
Working in a teaching hospital.
IMO, There’s a fine line between MD & RN when working in a teaching hospital. In my head, I’ve come to terms with knowing that, “I’m the nurse. You’re the doctor. Now give me orders!” I try to draw a pretty bold line in the sand so that no MD can come back and say, “well, it was the nurses fault…. she told me to!” I had a doctor call me back on the phone for a Ty order. Here’s how the convo went.
:::Ring:::
Me: This is (Me)
MD: Yeah……..
Me: Uhhh, my pt won’t po Ty (for a reason which I won’t get into to much detail here.. basically the pt had such a fit, he stopped breathing….’nough said) He’s in obvious pain and I know you don’t want to give MS for this sleep apnea. Can we give PR instead?
MD: Uh…..Yeah….
Me: (long pause) Ok so how much do you want to give?
MD: Whatever his Ty/codeine order was before, is the dosage the same for PR?
Me: I don’t think so.
MD: Well what’s the dosage range for Tyelnol PR?
Me: Sorry, I couldn’t tell you off the top of my head.
MD: Well just put the previous dosage range.
Me: Well, it says 1mg/kg/dose… I don’t think that’s right. If I have an issue fullfiling the order can I call you back?
MD: Well, I’d rather get this settled now.
(Mind you, I’m like feeding this MD information which I shouldn’t be doing.)
So basically he wanted me to find out what the dosage range for his order!!!!! Are you kidding me? I hate playing doctor/pharmacist/nurse/patient advocate at the same time.
It’s like dude, PLEASE. I’m like you’re supposed to look that up! So I said you know what this doctor doesn’t know what he wants, so I’ll just help him a little. If I hadn’t I wouldn’t have gotten what I wanted and that’s the thing about teaching hospitals…
If you don’t tell the MD what you want for the pt, you’re mostly likely not going to get it because 9 times out of 10, they’re not thinking about the obvious. That’s why as a nurse my job is a lot harder because I have to be one step above the Resident. Being a resident MD I know has major challenges.. don’t get me wrong. But sometimes I’m like, I should be MD if this is the way it’s going to be.
There were worst situations at work but it’s too detailed to get into so maybe another post =o)
But do you see my frustration? Trying to find what my role is as a nurse…but more so in a teaching hospital.
