Comments on: When You Don’t Know What You Don’t Know

By: NurseHubba

NurseHubba — Sat, 23 Mar 2013 16:25:04 +0000

I know I’m late, but. . .

Physicians do know more. They have faaaaar more extensive training. But, that being said, physicians are not gods. They are people too. And people make mistakes.

A good nurse, at least in my opinion, is not afraid to question a doc’s order, but should do so with tact and respect, and not in front of the patient unless there is a serious and immediate safety concern.

I’ve questioned doctors before about their orders (tactfully and professionally) and had them change their minds. Also, by questioning some of the orders, I’ve learned quite a bit because the docs teach me the rationale, helping me to understand better and, I think, be a better nurse.

By: SeaSpray

SeaSpray — Mon, 08 Oct 2012 05:11:10 +0000

I didn’t realize nurses could go against an ED doc in front of the patient. I would want one to go to bat for me if she knew something was truly wrong ..but I would think the physician knows more because of his training. ?

By: Jb

Jb — Fri, 28 Sep 2012 13:58:30 +0000

In the second case, the nurse was right out of luck. You went through the correct process of CT/LP. The MR came as a result of the correct sequence of events. If you did a normal MR first and there was a missed SAH, you would have no defense.
In the first case, the nurse was way out of line. If she disagreed with your management , then the nurse should have discussed his/her concerns first. If the outcome of the discussion was not to his/her satisfaction , then she should have gone to her supervisor. Most likely there is a process in place that avoids disagreeing in front of patients. The only ones who benefits are the lawyers. The nurse violated this and he/she should not be in the ED if this is a pattern.
I get along with all the nurses in our ED. They do question what I do sometimes, and we always have a friendly discussion. It never has gone beyond this. The only time, I complained to our supervisor was with a nurse who would openly berate the care that was provided .The problem was, she was just plain wrong. For example, we had a severely combative patient that required 9 males including 3 police officers to restrain . I ordered a chemical restraint. She then told a nursing student, ” it is always better to physically restrain rather than chemically restrain. What he did was not safe.”
She is no longer with us.

By: commonsensedoc

commonsensedoc — Fri, 28 Sep 2012 08:09:51 +0000

“It was then that I realized that the nurses were always right.” huh? you work in a toxic environment; not all nurses are like that;most know how to work as a team. #newjob

By: Charles J. Neilson MD

Charles J. Neilson MD — Thu, 27 Sep 2012 01:14:40 +0000

With regard to emergency nurses knowing more than emergency physicians ….. read this http://www.erbook.net/another%20point%20of%20view%20regarding%20nurses.htm

I think it is fair to listen to someone who has experience as both an ER nurse AND ER physician.

“Remember Rule #1 of the ER: Nurses can hurt doctors far worse than doctors can hurt nurses
#2 There are always a lot more nurses than doctors.
#3 Nurses occasionally fight amongst themselves, but if there is discord between a nurse and a doctor you can bet your last dime that the nurses will band togethert to assail the doctor.
#4 Cognizant of the above, ER doctors bend over backwards trying to avoid conflict with nurses.”

By: JJ

JJ — Wed, 26 Sep 2012 12:17:34 +0000

Why call a neurologist? They always say MRI/MRA.

By: JustADoc

JustADoc — Tue, 25 Sep 2012 20:05:08 +0000

Being lucky and being right are 2 different things.