What would you call "Practicing Medicine"

Hello everyone.
Just a curious thought for the day. What examples for a nurse "Practicing Medicine" can you give.

Ex: Giving meds without a MD order.
Changing med dosage without MD order.
Giving medical advice to your neighbors that does not include "See your doctor".

Here's an example of 'practicing medicine' that I've seen a lot of over the years. Nurses being so comfortable with the MDs that they write orders with the assumption:"Oh Dr. X will approve that--it's ok". It's NEVER ok to write an MD order with that kind of assumption.

Look up "scope of practice" on the BON site of your state. Anything not included is beyond your scope of practice.

I had a guy who was getting ready to be discharged to a NH/rehab (in an hour or so) and he had developed some kind of pain. So I called the doc and got an order for Morphine IV X 1 dose. Turns out, my tech had already d/ced his INT because we knew he would be leaving. Well, I was not about to call this doc back to ask him if I could change it to SC. So I gave it SC. Ooh, I'm so bad!I had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

Quote from NurseCherloveI had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

Quote from NurseCherloveI had a guy who was getting ready to be discharged to a NH/rehab (in an hour or so) and he had developed some kind of pain. So I called the doc and got an order for Morphine IV X 1 dose. Turns out, my tech had already d/ced his INT because we knew he would be leaving. Well, I was not about to call this doc back to ask him if I could change it to SC. So I gave it SC. Ooh, I'm so bad! I understand your frustration but you know you weren't supposed to do that and you should not be posting it here in public.I had a end stage liver disease patient the other day and this was the second day in a row that I had taken care of him. Well, in discussing his d/c instructions, I told him that it would probably be best to "stagger" his aldactone, lasix, and naldol throughout the day, the way I had been giving it to him because his BP drops too low. In the hospital, these meds were all ordered as "daily" which means to be given at 0900. His BP was already marginal both days, but I knew he needed these meds too. So I gave him the aldactone in the AM, the lasix at lunch, and the naldol late afternoon/early eve. Now, I don't think that was practicing medicine as RNs are allowed to use their discretion with giving meds. But, telling the pt to do this when he got home may have been questionable....ya think?

Nurses may not diagnose or prescribe. We are to observe and report departures from normal.I know it's unrealistic and old-fashioned and paternalistic and frustrating but that's the law. And unless you are going to medical school, learn it and obey. That's how you keep your license and your good name and your income.

Quote from TazziRNGiving medical advice to your neighbors that does not include "See your doctor".

If you are not an N.P., passing, drawing, giving, cutting, sticking anything into anyone.Woody

Quote from woody62If you are not an N.P., passing, drawing, giving, cutting, sticking anything into anyone.Woody

How about giving a fleet's enema that the doc ordered (after he was called asking for this order) -- having no success and deciding to go ahead with a soapsuds enema without an order?Oh and manual disimpaction after the soapsuds...Then a mineral oil fleet's for good luck...Is that practicing medicine???I'm seriously asking.....

Nurses in my ICU unit practice medicine by proxy all the time. We deal with a lot of surgical residents. When calling them for orders we frequently hear "What should I do?" or "What do you want?". Several times I have seen residents turn to experienced nurses when a patient is crashing and ask for help. I have seen residents write orders word for word the way the RN "suggested" it.