You’re a Nurse. Don’t You Have to Do What The Doctor Says?

“You’re a nurse. Don’t you have to do what the doctor says?”

Pulcinella (Punch & Judy) oil on canvas by jparadisi 2011

I check my iPhone to be sure the year is still 2012. I have not magically transported to a nursing station in the past, say 30 years ago, because it’s been 30 years since someone has asked me this question. I can’t believe the woman on the other end of the phone asks it now.

She answers phones at a doctor’s office. I want to say, “You have to do what the doctor says, because you’re his employee, not me,” but I don’t. She isn’t being rude.  She doesn’t understand the role of a Registered Nurse.

“This is an opportunity to educate,” I says to myself. So I give it a go:

“Nurses work with doctors, administering the medications they order to patients. However, it is my job to also prevent patients from harm as a result of their medications. I am calling to tell the doctor I cannot give this patient her medication today, because of her lab values. We have to reschedule the medication, when the lab results improve.”

“But the doctor wants the patient to get the medication today.”

“I know. Giving it today may harm the patient. I’m not calling to ask the doctor if I can give the medication. I’m calling to tell the doctor the infusion will be rescheduled.”

You do not understand! The doctor wants the patient to get it today.”

“I do understand. It is not safe for the patient.”

“You’re a nurse. Don’t you have to do what the doctor says?”

Sigh. “Is the doctor available? May I speak with him, please?”

2 thoughts on “You’re a Nurse. Don’t You Have to Do What The Doctor Says?

  1. Wow. What you report is a little scary. As you say, the key word is “advocacy.” A nurse’s first responsibility to scope of practice is patient safety. More times than not, this means following the doctors orders, however, we assess the patient’s condition and lab values first. This should not put nurses in an adversarial role against physicians. It is a process of checks and balances, for the purpose of safety. It protects doctors too. They don’t want their patients harmed by a treatment or medication they ordered either. Many times doctors have thanked me for calling with concerns. In healthy work environments, doctors and nurses work as a patient care team, not as adversaries or subordinates.

  2. There are still nurses today that report that in my hospital: ” I have to do what the doctor says. ” I attempt to enlighten them about advocacy for their patient. They don’t get it. One even replied “I have to follow my scope of practice, I have to do what the doctor says.”

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