Wednesday, June 22, 2016

Doctor's Orders VS Nurses' decisions: Whose is more efficient?

  In the world of medicine and in a healthcare facility, there is always one big argument. Who has more authority over a patient? The doctor that determines the sickness or the nurse that takes care of the patient? Who has more authority period in a healthcare facility? A doctor that has more schooling under his belt; a nurse that knows the hospital like the back of her/ his hand? Questions like these and many more are asked on a daily basis. While reading this text, many aspects will be looked at. What are the duties of these occupations? How does this apply to the patient?

   Before getting any deeper into the intense argument of these careers, what are the duties/ accomplishments of a nurse? A doctor?  According to the website, KevinMD.com, one of the main differences is the schooling and degrees. A nurse can have an undergraduate degree in nursing, while doctors have to go through school to have an undergraduate degree of some sort plus earn a MD while in medical school. Does that make a doctor more intelligent or powerful? Absolutely not! While a young doctor might have documented that he/ she are a doctor does not mean that nurse that has been working the same job for 20 years cannot be smarter. The same goes for the other way around. Just because you have a large amount of schooling, does not give you the power to say you are smarter. It is like comparing a lawyer to a professor. Who has more knowledge? Another point the website pointed out is that depending what type of nurse/ doctor the person is, defines how much money the person will annually make. Yes, that does mean that a nurse can make more than a doctor! What are the responsibilities? Well, a nurse has to take care of the patient, while the doctor finds the problem. They are both dealing with some critical jobs, so who has the say to tell which one is more valuable? In all, there is really no difference to being a nurse or doctor when it comes to authority.

  After going through the basis of a nurse and doctor, here is an example of one the biggest problems that are dealt with today. A nurse is given an order by the doctor to not rule out chemotherapy for a leukemic patient. This patient has suffered many of painful nights of bleeding, cramps, and many more terrible things. This patient has been known to complain about the medication, how is causing the death of him, how dreadful it was. The nurse sees it all and goes to tell the doctor. She was the patient’s care-giver after all and wanted the patient to live his last days in not such terror. The doctor was angered by this plead, going to the patient himself and persuading the poor patient to continue the treatment. To put into shorter terms, the patient lived his last days in agony. This is what happened to and nurse names Theresa Brown and she wrote an article about how it was often for a nurse to disagree with a doctor in drastic moment like this. Was Nurse Theresa right to go to the doctor about the patient’s complaints? Was it right for this doctor to proceed with the chemotherapy, knowing that the treatment is causing more harm than good? Does the nurse even have the right to go against doctor’s orders? This goes back to the argument of what a doctor was and what a nurse was. A nurse is NOT under the authority of a doctor. They are under the hospital’s rules and regulations. This means that a nurse can go against a doctor. If a nurse feels that a doctor is doing wrong, then she/he in every which way can deny the order and decide what is best for the patient. Nurses also have the right to confront a doctor about these wrong doing as long as it is professional and confidential. That means a nurse cannot just disrespect a doctor in front of the patient. Like before this also goes for the doctor as well. If she/he sees a nurse treating a patient inappropriately, then it is his/her right to throw the flag and disagree with the behavior. With that said, no one has more or less power to determine what is right for the patient. 

  There is one more perspective to look at when talking about a patient health. That perspective is the patient themselves. What does the patient want? What are they comfortable with? Some physicians like the one in Brown’s case would say that if a patient is in critical condition that it is the doctor’s decision from that point on. Some nurses might say that it theirs! They are both very wrong. If a patient is still conscious, then they have the right to say no to treatment of any type. If a nurse or doctor goes against that right, they can get in tremendous trouble. The patient is the leg that completes the triangle of decision making. The nurse, doctor, and patient all have to communicate to find the best solution that benefits the most.

  In conclusion, no matter if a person is a doctor or nurse; they both have high expectations and standards they have to succeed when working in a healthcare facility. No one has higher power based on the job they have. In reality, power really consist on what reputation a person has had in the past. That means a nurse can technically boss a doctor around just because the supervisor of the hospital thought that was the job for her. When it comes to patient, not only can a nurse object a doctor’s order (or vice versa), but a patient also has the power to object both decisions. In all, when everything is analyzed and put together, there is really not a big difference between doctors and nurses. 

Who do you think has more power in a patient's care? Comments below!   

The amazing sources (in MLA format because I am feeling extra professional!):


Brown, Theresa, RN. "When the Nurse Disagrees With the Doctor." New York Times. New York Times Company, 13 Oct. 2010. Web. 20 Jan. 2016.

Berman, Steve. "When Nurses Should Argue With the Doctor." Nursinglink. A Monster Community. Web. 20 Jan. 2016.

Malone, Patrick. "When Doctors and Nurses Disagree About a Patient, Who Decides?" Jdsupra. JD Supra, 20 Oct. 2010. Web. 20 Jan. 2016.

Lend, Shirie, MD. "The Only Thing That Truly Separates Doctors from Nurses." KevinMD. KevinMD, 3 Apr. 2013. Web. 20 Jan. 2016.

   


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