TELLING A DR. YOU DISAGREE WITH THEM! 

Nurse Bass make it 10!

Nurse Bass this was me yesterday tbh

Aaron McCray great idea!

Let me preface this by saying that I know nothing. That said, what I've seen is that protocols seem to place emphasis on minimizing the appearance of negligence and minimizing opportunity for litigation. Documenting a nurse's disagreement with a doctor's order would surely create quite a pickle as far as BOTH of those go. That's all I've got. Can't wait to hear some more on this. Great video

Stanzavik I see where you are coming from! You have to be careful what you're "disagreeing" with. Bringing concern in regards to an order has to be done tactfully. With that being said, not every protocol is appropriate for every patient.

Ashley Adkins, RN I definitely agree, you do have to phrase things tactfully. When I was a scribe in the ED during the beginning of nursing school and I was charting, I believe it was a consult the physician had called, the physician reviewed what I had put in and said something like, "we can't phrase it this way; lawyers will be all over this." However, I feel that it is important to say that, while you do have to be tactful and objective, you do still need to be honest. The last weekend I worked, the ER sent up a septic, hypotensive (when she came to the floor, our machines wouldn't read a pressure above 69 systolic and she was 112 systolic before leaving the ER - came into the ER 80/40 and tachy in the 160s), neutropenic patient with a rigid abdomen (no ABG, not imaging studies done) who should've gone to the ICU and not to a med-surg floor. So we ended up calling a rapid response within 10 minutes of the patient being on the floor. After we got her transferred to the ICU, I had to go back and chart about what happened and how my charge nurse disregarded the information I was telling her about the patient before the patient came to the floor (before ER even called report to me) and my concerns for the need for an ICU bed instead. And when you're put into a situation like that, it can be difficult to be tactful. I'm pretty sure I spent about an hour writing a progress note on that rapid response because I kept reading, rereading, and rephrasing different things for it to be tactful and objective.

Brit B absolutely! Typically I would chart at the time I talked with the dr and would say something along the lines of "notified MD of concerns regarding XXXXXX, no further orders received."