For my part, I've never been at a place where the nurses put in the orders or call for tests. I'm shocked. Where are you guys training, I need to get in on some of that action! My point is that I personally don't mind Clio's suggestion that physicians do that stuff but I'm obviously biased because I've never known anything else. I can see where if you come from a place that nurses are supposed to do it, you say, "why do I have to do her job?"
Just to clarify, I was referring to us having to be a go-between when other departments have problems with the docs' orders. If I'm relaying messages from the pharmacist to the doc and back again--- over and over, I can guarantee you there's going to be something lost in the translation. I was lucky that the night pharmacist I worked with would contact the docs himself with questions and, more importantly, correct obvious errors without all the drama I encountered from the others.
I don't mind entering orders. In fact, I prefer it to an extent. Maybe it's my OCD kicking in, or maybe it's because that's what I'm used to doing for so long... but I like to know what's happening with my patients and when the docs are putting in their own orders, I feel something is missing. And as crazy as it sounds, I also miss the "24hr checks". I can't tell you the number of times I found mistakes, whether by the doctors, nurses, or the ancillary staff.
In my first university hospital contract, I was told by my preceptor that I was absolutely NOT to double-check orders, that it was on the docs' heads if something was ordered wrong. When I questioned how they managed to catch mistakes in these orders, or simply ensure that orders were carried out correctly, I got that ol' "third eye" look again. She said it didn't matter, because it wasn't nursing's fault. I think
that is screwed up. This blame-game crap is ridiculous. And who suffers as a result?
But I'll say this, too. Despite the fact that I order the tests and place the orders and deal with the techs, the nurses where I am still complain that I should do more work. When they get calls from Pharmacy, they literally just page me and tell me to call Pharmacy because they have a problem. When they get calls from Radiology, they just give them my pager. And even with that, they're still not doing lots of nursing things or paging me without thinking and start reading me random vitals just so they can dump a problem in my lap. The popular "can't get an IV" call is great because I'll have to put all my other duties on hold and labor at getting an IV and, just like Noble Gas said, meanwhile the nurses will be reading magazines or chillin'.
One resident I know says this behavior is because nurses are unionized. She told me that a resident she knows works at a non-union hospital and it's heaven. This resident she knew had to put in a central line and the nurse got all of the materials, then paged the resident, and stayed bedside to assist with anything and was polite the entire time. At our hospital, the nurse isn't even in the equation and what's more you have to go tell her when you're done and she'll yell at you to use more chucks if you got blood on the sheets. On hearing about the non-union hospital I honestly almost had a wet dream in my pants.
Well I'm not union lol.
I have no use for abusive nurses. Or anyone for that matter.
I have no interest in aggravating the docs I work with; I have better things to do. And don't take this the wrong way, but I don't page y'all for fun, either. I page when the patient's status deems it necessary. I have paged when it's not clear that the doc is aware of abnormals or consults or whatever. When it's not documented one way or the other, I'd rather err on the side of caution than assume he or she was notified earlier.
The docs I worked with for all those years (before I changed jobs) were incredible; they knew me, I knew them. I knew what I could do without paging, I knew when to call them. One had lost his partner and was on call
all the time. I did my best to avoid calling him unless it was absolutely necessary. Since I left that job, I probably page more than I used to; at least until I get to know these doctors, I will have to do so.
As night charge, I've also advised other nurses to page--- or not. One recently came to me with a "critical" low calcium level, and asked if she should call the doc. I sat with her for some time, showing her the albumin level (waaay low), the previous days' calcium and albumin levels (also low), the progress notes (doc was aware of the patient's labs on previous days), how to calculate a corrected calcium level and told her "No. Don't wake him up for this."
So what did she do after all that? Called the doc. Who proceeded to tell her pretty much the same stuff I had, only he wasn't so nice about it. Then she comes back to me in tears because "the doctor was mean to me".
Stuff like this makes me want to pull out my hair.
I am too old for these grade-school games. I'm here to do my job. It does me no good to **** off the doctors with ignorant pages, and like I said, I have better things to do.
