u/glass_gremlin

I travel to different ICUs around the US, and I occasionally take LTAC contracts. What I’ve noticed is the glaring disparity of respect I receive depending on which role I’m in. When I speak to physicians when working in an ICU setting, they normally take into consideration what I say and if they disagree then they will explain why. On the contrary, physicians in the LTAC setting do not seem to have the same rapport with nurses.

I’ve also noticed that colleagues (other nurses) generally do not have respect for the work that LTAC nurses perform. Is it an issue of understanding? LTAC is high acuity, high nurse to patient ratios. It takes a lot of dedication and knowledge for nurses to work in the LTAC environment.

What are your thoughts? If you haven’t worked in an LTAC, what is your understanding of what the work entails?

How many of you other RNs ask doctors for specific medications? I floated the other day to a lower acuity floor and I asked the doc if they wanted to do an ABG and the charge nurse basically told me to stay in my lane. That experience made me question if I am going beyond my scope by asking for specific meds like seroquel, hydralazine, etc. How often do you contact the docs for specific orders? Or do you play the game of “Patient is doing X” hoping the doctor orders “Y” without explicitly asking for it?