I could not agree more.  If I have concerns about  a M.D. order, I DO
question the physician about it.  As stated, I'd lose my license if I
blindly followed an order that way.  Most times, I can get a good
clarification on things.  And as Melinda stated, most physicians do value
our input.  If a doctor continues to order something I am not comfortable
with, I do have options.  I can refuse to carry out the order and provide
documentation as to why and what I did.  Or, I can go ahead and carry out
the order, but also provide very clear documentation that I questioned it
and that the physician still wanted it carried out.

I am very careful with and protective of my nursing license.  If something
went wrong and I had to stand in a court of law to defend my actions, I
doubt anyone would be supportive of "well, the doctor wrote an order to do
it".  On the contrary, I'd be held liable because I am a professional and it
would be expected that I used professional judgement in my nursing actions
and decisions.  Anyone can follow orders on a piece of paper.  But I have
the assessment skills necessary to make critical nursing decisions - and I'm
expected to exercise those judgements on a constant basis.

Realistically, we DO refuse some things.  Realistically, we will not be
unemployed for doing so.  And we are not expected to "go along with the
status quo".  Yes, there are difficult hospital cultures to overcome, but
regardless of what is going on, I'd never put my nursing license in
jeopardy.  I'd sooner walk out the door permanently and voluntarily before I
did such a thing.

Christina Harris, RN
Seattle, WA


On 3/15/07, Tom & Melinda Lueck <[log in to unmask]> wrote:
>
> Pam writes:
>
>
>
> "The only thing I can come up with is that in a hospital setting, a nurse
> is
> not allowed to contradict an order. It doesn't matter what the order is,
> she
> follows it. Yes, yes, it is not true, she is supposed to refuse, but
> realistically that is not the work world and she will be unemployed or
> whatever if she doesn't go along with the status quo."
>
>
>
> This statement helps me understand non-nursing IBCLCs a little better, if
> this is really what you think it is like in a hospital setting.  That is
> NOT
> what it is like---nurses question doctors all the time, without any fear
> of
> losing their jobs.  We do NOT blindly follow orders.  We would lose our
> licenses if we did.  I would not say that we go in and tell the patients
> to
> ignore what their doctors have said and flatly contradict them, but we do
> have the freedom to give patients information so that the PATIENTS can
> also
> question the doctor about their options.  If done in a tactful and
> respectful way, most physicians value our input.
>
>
>
> Melinda Lueck, RN, BSN, IBCLC
>
>
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