Minnesota RNs facing competition from less-qualified

[tncekm]

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Thank You okayplayer. I appreciate your kind and informative answer.

Okay, now you need to see the bigger picture. You've got your answer as to why there is a good reason for the three medications being given at the same time. But, that's really irrelevant. What is important here is that you're not trained to understand the physicians decision. So, instead of giving the patient medical advice about something you don't understand, bring your concerns to the physician. Maybe you'll find that your concerns are valid, other times (like today) you may learn something new. You're a nurse, not a physician. And, while it's okay for you to have questions and concerns about medical decisions and ask the attending physician why a decision may have been made, it's not okay for you to give medical advice to patients. <-- This is what physicians here have a problem with.

 

[DutchgirlRN]

Okay, now you need to see the bigger picture. You've got your answer as to why there is a good reason for the three medications being given at the same time. But, that's really irrelevant. What is important here is that you're not trained to understand the physicians decision. So, instead of giving the patient medical advice about something you don't understand, bring your concerns to the physician. Maybe you'll find that your concerns are valid, other times (like today) you may learn something new. You're a nurse, not a physician. And, while it's okay for you to have questions and concerns about medical decisions and ask the attending physician why a decision may have been made, it's not okay for you to give medical advice to patients. <-- This is what physicians here have a problem with.

Tncekm Okay, now you need to read the thread to see the bigger picture. I never said I was trained to understand the physcians decision. I don't give patients medical advice, I call the doctor and let them make the decision. I am a nurse and I am proud of being a nurse.

Thank you for informing me that it's ok for me to have questions and concerns about decisions the physician makes...that's part of my job 🙄

Doctors are not infallible and I have found mistakes doctors have made in writting orders and no I have never reported a doctor in 34 years of being a nurse, in the same hospital, until this year and it had nothing to do with meds. Likewise I have never been reported by a doctor, a nurse, a dept head. Not one write up ever.

If you had read the thread you would have read that we have come to a mutual understanding and we respect each other's jobs.

You did the right thing and you did exactly what I would expect.

I suspect that Dutchgirl is one of the good ones. I have read some of her stuff on this and another board and she seems to be the type of nurse that I would enjoy working with.

- pod

Stop trying to beat a dead horse, it's not becoming...

 

[Consigliere]

So Pod, enlighten me..... you've got my curiousity peaked, I work in IR. I do conscious sedation, push Lopressor, etc... Never heard of a CT anesthesia fellow.

God you're an idiot. Google it dummy.

 

[DutchgirlRN]

God you're an idiot. Google it dummy.

I don't understand how calling me an idiot is supposed to make you look smart? Are you looking for a platform to espouse some inane observation or spue some hatred?

 

[Eta Carinae]

I believe Consig may have mistaken you for a troll (as I did earlier on this thread).
Pardon, si vous plez. 🙂

Nothing personal intended I'm sure.

 

[DutchgirlRN]

Wow, it can get rough in here. Is because you have problems with Trolls or because I am a nurse? Just Curious 😉

 

[Paseo Del Norte]

I have not been a member all that long; however, trolling does occur. I think people are always going to question the motives of a nurse making connections to the APN mess, even if your intent is otherwise. In addition, some hostility will always be present on any forum; however, take the good with the bad. It may take a little time for people to sort out your agenda.

 

[DutchgirlRN]

I have not been a member all that long; however, trolling does occur. I think people are always going to question the motives of a nurse making connections to the APN mess, even if your intent is otherwise. In addition, some hostility will always be present on any forum; however, take the good with the bad. It may take a little time for people to sort out your agenda.

I guess I'm naive that trolling a professional site does occur. I was googling something and came across this forum. While I am not a doctor, I think however, we can learn things from each others points of view. Some of the posts found here go way over my head but others are very interesting to me.

 

[Dejavu]

Having started out life as a diploma nurse, got a degree, went to CRNA school, worked a decade, went to Med school, anesthesia residency, attending for another decade (you all can guess how old I must be (oh yeah, forgot 4 yrs in the Marine Corps first before this all happened)), I find this thread interesting.

DutchRN--I sincerely wish I had the opportunity to work with you. Even in the face of provocation (getting called an idiot, etc) you maintain a professional demeanor. I applaud you. I work with many like you and thank God for them every day. As you say, a good nurse will save your ass sometimes. May you have a good tail-end of your career.

More than anybody thus far, I can appreciate what each member of the team brings to the table to help take care of the pt. Roles are clearly defined. We should each help the other to do the best for our pts. Our DutchRN friend has shown class by acknowledging these roles for what they are.

Just my two cents, hopefully without adding anything controversial. I hate controversy.

 

[tncekm]

Tncekm Okay, now you need to read the thread to see the bigger picture. I never said I was trained to understand the physcians decision.

Okay, then how do you explain the below statements that you made? A few of the physicians here asked you to explain yourself, and you never did. Doing stuff like that makes you come off as a "troll".

A nurse knows a patient shouldn't be taking asa, plavix and coumadin and a nurse knows why. I had a home health patient with an inr of 13.2 i reviewed her meds and she was taking all 3 of those meds. She told me when she got home from the hosp her coumadin was no longer on her med list so she called the office and the "nurse" julia told her to continue to take the coumadin. I called the office to learn that "nurse" julia was an ma with 6 months experience.
...
No, if you had read my post you would have read that at the time the patients INR was 13.2 I would dare say even the dumbest of doctors wouldn't add coumadin to this patients med list?

I agree that the MA should have not passed herself off as a nurse, and she should have consulted the physician when learning there was a discrepancy in her treatment.

However, what people have a problem is with you passing judgement on a physicians decision when you clearly do not understand it. You then, maybe unintentionally, implied you would have told the patient not to take the coumadin in several posts. That's fine if it's a decision that the physician made after you consulted him/her, but it didn't sound like that's what you had intended after reading several of your posts about the topic.

I don't give patients medical advice, I call the doctor and let them make the decision. I am a nurse and I am proud of being a nurse. Thank you for informing me that it's ok for me to have questions and concerns about decisions the physician makes...that's part of my job 🙄

Well, you made it sound as if you were giving medical advice. That's what got people worked up. Considering the firestorm the nursing union is creating, people around here are a bit sensitive to that kind of stuff.

If that's not what you meant, then I apologize for misunderstanding you. But, it wouldn't be the first time a nurse had made their wait to the forums only to tell the physicians how useless they are and that they're essentially over-pain NP's.

Doctors are not infallible and I have found mistakes doctors have made in writting orders and no I have never reported a doctor in 34 years of being a nurse, in the same hospital, until this year and it had nothing to do with meds. Likewise I have never been reported by a doctor, a nurse, a dept head. Not one write up ever.

Of course they make mistakes. That's why I said that if you have a concern about a medical decision, you should ask.

If you had read the thread you would have read that we have come to a mutual understanding and we respect each other's jobs.

That's all great. I do respect nurses so long as they're doing their job. And, to tell you the truth I generally enjoy my time with nurses. Many more of them are from blue-collar backgrounds like myself, and we tend to "click" better than I do with most med students / physicians. You just didn't seem to get "why" some of the people here were irritated by some of the things you said earlier in the thread.

 

[DutchgirlRN]

Per post #67

I have unintentionally conveyed my thoughts wrongly by saying nurses understand why. To be fair....I never said I fully understand medicine. What I should have said is that nurses know when to question an order because they understand the consequences of not doing so.

I never said I made a judgement about a doctors decision.

One more time: I had a pt to admit to home health, she had been discharged 24 hours earlier. I have to reconcile the home meds with the meds that are listed to take @ home on the discharge papers from the hospital.

I had an order to do her INR. It was 13.2. I did see the ASA and Plavix on the discharge orders but not the coumadin. I told the patient that I thought the doctor would probably want her to hold it for a while and that we would call. She said she had already called that morning because she wasn't sure if she should have taken it the night before or not and she said the "nurse" (medical assistant) told her to continue taking it as usual. Coumadin 8mg QD.

I called the doctors office and the MA said to me "I already told her to take it as usual". I asked her where she got that info and she said off of her chart. I told her I had to talk to the doctor. The doctor said 13.2 have her continue to hold the coumadin, recheck it in (I think) in 3 days and call me back with the results. I told him I had drawn it peripherally also as a back up, to be run stat and if it was different I would call back shortly.

I have always believed that people have the right to express their opinions and to explain theirselves or their actions but that it needs to be done in a respectful way. I do not let members on my forum call anyone an idiot. I do own my own forum www.justusnurses.com and do not have trouble with trolls. What I do get is people wanting medical advice and I send them here (just kidding!) no we tell them we cannot give out medical advice and that they will have to see a physician and if no insurance go to the "PA in a box" if they can afford that, otherwise, sorry, Good Luck, we can't help you.

 

[DutchgirlRN]

So, the dog accidently jumped up and sent the post

I do not question doctors orders but I do have a brain and if I think the doctor has made a mistake I will question it. I have found mistakes that doctors have thanked me for questioning. In 34 years I have never reported a doctor (and I could have) until a couple of months ago. People make mistakes and that can be dealt with civility.

The jerk I reported was just flat out wrong.

I'd like your opinion if you'd like to hear about it.

Do I need to start a new thread in a different area or should I just go ahead and dive for cover now?

 

[Paseo Del Norte]

I am not sure this thread is the proper venue to discuss such things.

 

[Arch Guillotti]

The jerk I reported was just flat out wrong.

I'd like your opinion if you'd like to hear about it.

Do I need to start a new thread in a different area or should I just go ahead and dive for cover now?

I don't want to hear about it and I doubt many others around do either.

 

[DutchgirlRN]

That's cool. Outta here ---------> 😉

(Just seems to me most are too quick to dump on a nurse but don't want to hear anything negative about a doctor).

Everyone can learn from others mistakes. The thread re the most ridiculous thing a nurse has called you for is not flattering to nurses but hey it's the truth, those nurses were obviously not thinking clearly. I can admit that nurses are not all are angels of mercy.

Maybe I'll get brave and post it in the Radiology section since it was a Radiologist who blundered.

 

[fab4fan]

That's cool. Outta here ---------> 😉

(Just seems to me most are too quick to dump on a nurse but don't want to hear anything negative about a doctor).

Everyone can learn from others mistakes. The thread re the most ridiculous thing a nurse has called you for is not flattering to nurses but hey it's the truth, those nurses were obviously not thinking clearly. I can admit that nurses are not all are angels of mercy.

Maybe I'll get brave and post it in the Radiology section since it was a Radiologist who blundered.

Dutch, with all due respect, I really don't think it's appropriate for you to be taking your grievances about a doc to a MB for doctors hoping to get support.

I appreciate that nurses have been welcomed here, but one of the best ways to sour that relationship would be to start posting the sort of stories you're looking to post. Even if you were right in the situation you're thinking of, how would posting about it here change things other than boosting your image? It wouldn't change the doc, if he's hard to work with, and it wouldn't change things for the pt.

And cross-posting in other forums will gain you no friends here. Please don't spoil things for the rest of us with your need for affirmation. Just some friendly advice.

 

[DutchgirlRN]

Dutch, with all due respect, I really don't think it's appropriate for you to be taking your grievances about a doc to a MB for doctors hoping to get support.

I had an interesting situation and wanted any opinions on how "I" might have better handled it because it just might come up again.

Even if you were right in the situation you're thinking of, how would posting about it here change things other than boosting your image?

I don't have a need for affirmation. And I would have started a seperate thread. Apparently no one wanted to hear it so I didn't post it.

I truly have a hard time understanding this forum. On my nursing forum we vent. It's cathartic. We discuss nurses @ work who piss us off. We do it respectfully. What's the big deal? No one on my forum knows the nurses that we discuss and if we discuss another co-worker or a doctor we don't use names or locations. It's better than drinking or downing some benzo's.

I'm moving on we've gotten way off topic here. Peace.