Question

Judgments about physicians' orders:

The word autonomy literally means "self-governing." The concept of nursing autonomy can be discussed on two levels: the autonomy of the profession and autonomy of the individual practitioner. Self-regulation is the mark of collective professional autonomy. Individual autonomy involves self-determination, responsibility, accountability, independence, and a willingness to take risks. Autonomy is generally considered to be an important criterion in judging the professional status of occupation. However, we continue to debate whether nurses have autonomy (Burkhardt & Nathaniel (2008). Ethics & Issues (3rd. ed.).

Nurses are frequently asked to give medication with which they are not familiar. Unable to quickly determine the appropriateness or safety of a given drug, nurses may decide to refuse to administer a particular drug. Discuss:

1) What feelings, emotions, and values are involved in the nurse's decision to refuse to follow a physician's order?

2) What are some predictable reactions of the nurse's coworkers, supervisors, and physicians when a nurse refuses to follow a physician's order?

3) What ethical principles can be used to guide such decisions?

4) How is the nurse empowered in these types of situations?

Answer 1

Ans) 1) No a nurse does not always have to follow a doctor's order. However, nurses cannot just randomly decide which order to follow and which not to follow. Safety concerns are one reason why nurses might not follow a doctor's order. One of the most common concerns surrounds medication.

2) As one can see, there are times when nurses must decline to follow a physician's order. The nurse has the responsibility to inform a supervisor as well as the physician immediately to prevent patient care delay. Failure to do so may constitute negligence.

3) All nurses must be professionally accountable and use clinical governance processes to maintain and improve nursing practice and standards of health care. They must be able to respond autonomously and confidently to planned and uncertain situations, managing themselves and others effectively.

4) By partnering with professional associations, health care organizations gain an ally in leveraging the power of the staff nurse. ... However, nurses often do not feel empowered to use their expert knowledge to devise innovative solutions that improve patient outcomes.

- 3 Ways to Empower Nurses to Become Effective Leaders:
• Provide Leadership Development. Experts say that leadership skills can be learned through effective training programs.

• Involve Nurses in Shared Decision-Making.

• Giving nurses a voice in key hospital decision-making can offer a great sense of inclusion and appreciation.

• Offer Continuous Feedback.