Situational Nursing Mock Interview
Practice 50 Situational Nursing interview questions covering clinical judgment, patient safety, and critical response scenarios.
Question 27 of 50
How do you handle situations in which you disagree with a doctor's orders?
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Dianne Barnard is a Registered Nurse and former nursing instructor. She is also board certified in Psychiatric Nursing and Holistic Nursing Critical Care.
Nurses follow doctor's orders, but sometimes there are orders that a nurse feels are not in the patient's best interest. For example, if the doctor orders an antibiotic that the patient remembers she is allergic to, then it's easy for the nurse to tell the doctor that a different alternative is needed. But sometimes, the nurse disagrees with the validity of treatment that the doctor and patient agreed on. It's always helpful to say your dissension for the big stuff. You are more likely to be heard if you are known as a reasonable nurse who strives for excellence in their work ethic. If you have reasonable questions, ask the doctor if you could have several minutes of his time. Organize your thoughts, put your emotions in check, and outline your thoughts and rationales. The best outcome would be that the MD would do the same and it would be a learning moment. There is a chance that the doctor will not be as receptive as you would like and you will not impact the decision, but that should not stop you from advocating for your patient in a plain and reasonable manner.
Dianne Barnard is a Registered Nurse and former nursing instructor. She is also board certified in Psychiatric Nursing and Holistic Nursing Critical Care.
"Dr. Welby, may I speak with you for a minute, privately? I see that you wrote an order to increase Mrs. Steinway's pain medication. I understand that she is rating her pain as a 10, and that's concerning to me, as well. However, when she takes her pain medication, she gets very tired and then refuses to get out of bed for PT and that has always helped her pain tremendously. Is there anything else we can do to help manage her pain, while still allowing her to have the energy to do the things she enjoys and that help her?"
"If I don't agree with a doctor's order, it's important to advocate for my patient in a respectful way. I once had an experience when taking care of a patient with an acute exacerbation of his heart failure. His doctor ordered a high dose of IV Lasix, and he said he was going to order a Foley catheter to make it easier to get a strict intake and output record for this patient. However, the patient was alert, oriented, and not a fall risk, and per our hospital guidelines, we shouldn't jump straight to using a urinary catheter in this case. The catheter could put the patient at risk of infection and skin breakdown. So, I asked the doctor if I could try using two urinals in the patient's room and providing the patient with education about why it was so important to record his urinary output. I also assured the doctor I would put a reminder sign above the toilet in the patient's room, reiterating the teaching to use the plastic urinal rather than the toilet. The doctor agreed to remove the catheter order, and we were able to accurately record the patient's urinary output without it."
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