This post is part of the problem in healthcare, nurses should be supervised by doctors. Not job supervision, but clinical supervision. Nurses have to carry out Dr orders and if they feel they can disagree and take it through some nursing heirarchy before they honor the order, that is a problem. I have seen it happen, and the barrage of BS that comes from the nursing union in support of any nurse questioning an order regardless of merit.
No, dear...MDs are a different profession, and few MDs know anything about nursing practice as given by the erroneous statements on this BB and the inappropriate orders that I have seen written in my career.
Part of it is checks and balances. I have dealt with enough incompetents (they are in both fields) and egoists (ditto the previous comment) to know that both are important to the patient's health.
You are an MD, fine...but frequently MDs do some really stupid things that endanger MY license. And, silly that it may seem to you, my license/reputation/good name is as important to me or more so than yours. If you, the MD do not like the care that I give, you may speak (not yell or belittle) to me. If you are not satisfied with my response, you may speak to my nurse manager, who can either censure me if I am out of line or refer you to legal/the medical director...if you (as often is the case) are out of line. And if you are not satisfied with that, you are more than free to admit your patients to a unit or a facility that meets your standards.
You have plenty of options for caring for the patient. And you have more than enough options for obtaining what you consider adequate care for your patient.
Be also aware that few of us are "unionized" and that unions rarily involved in whether we consider your order inappropriate. Unless you are asking to do something outside our scope/legal practice. But unions often involve themselves in unfair firing/disciplinary actions. Unions also cannot keep an incompetent nurse from being fired (though they do make it more difficult). It also makes harder to fire the "bad attitudes" which annoy all who work with them - nurses, MDs, PTs, Housekeeping, etc.
I do not work union shops and prefer not to.
But you do not have the inherit right to supervise other departments, in which you do not have the appropriate (note I said appropriate, not better or more) education and background. Just as it would be inappropriate for a nurse to supervise/discipline MDs on their MEDICAL practice, it is inappropriate for an MD (especially with no nursing education/experience/knowledge of scope) to supervise nurses.
(This despite the well published attending that told me that I should have "forced" a resident to order antibiotics at night. Maybe y'all should do your jobs and let me do mine before trying to dabble in supervising me)
This has recently be upheld in state courts. One of the midwest state courts recently ruled that MDs cannot serve as expert witnesses in court regarding nursing scope of care, partially because they receive no nursing education.
I am not radical, guys. And this is not a radical idea. I feel that midlevels SHOULD have supervison and that there should be substantial oversight of midlevels. I'm cool with y'all wanting to keep prescriptive privileges.
But do recognize that there are checks and balances in the health care system. MDs are not G-d, and frequently screw up. Hopefully, nursing/pharmacy/OT/PT prevent that. And part of that means those individuals are frequently not under your control, for a very good reason.
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PS. There are facilities where departments cross over, or where MBAs rule the roost. They are generally unmittigated disasters, resulting in poor morale, staff hemorrhage, higher mortality rates, etc.
