Can a doctor override a nurses view not to sedate a patient?

Answer 1

Your question does not include enough information to give a complete answer. Ordinarily a licensed doctor has the authority to write prescriptions and RN's do not. If the nurse is a licensed Nurse Practitioner he/she has more authority than an RN, however, a doctor outranks them all. The nurse practitioner may be given the authority to diagnose simple things and prescribe from a list of drugs approved by the doctor. The Doctor Who authorizes the nurse to order these drugs has to counter sign the prescription and the doctor is liable for whatever happens. That is why most doctors are reluctant to surrender any authority to any nurse. They want to see the patient they are responsible for. If the doc makes an error he is always liable for this, therefore he wants to see the patient and he is right in his decision here.

There are slightly different rules for a practice in the hospital vs the military hospitals. You did not include whether the situation you describe was in a hospital or private practice or the patients private doc in the hospital. Unless the patient is on death's door nobody will interfere with another doc's patient. This is a matter of ethics. In situations where they are overloaded with patients it is common for a doctor to allow his nurse to do more so that he is not tied up with simple things. There is a "triage" nurse to decide which patient is seen first and who waits or who can be saved and who is too far gone to be saved at that time, however, the nurse does not ordinarily, treat any of these patients. There are times where these decisions have to be made and only a properly trained doctor should make these decisions. A board certified Emergency Room doc is trained for this. Many docs do not want this responsibility.

The training of any nurse can not be compared in intensity, depth and time (years), to the training of a doctor, consequently, the RN may have an opinion (view) but it is not based on the same background that a doctor has. That is why only doctors do surgery not nurses. Nurses assist in many situations but do not initiate them. There are so many more aspects of medical care like pharmacology, drug interaction, diagnostic skills, patient history, and patient physical examination (nurses are not trained to do), that the ordinary person has no idea of what it is all about. Nurses may do "vital signs" like blood pressure, temperature and pulse. This is important but she is only reading and recording what the machines are doing. I've noticed my doctor redoes my blood pressure a couple of times after his nurse does it. I used to do this when I was a Pharmacist's mate in the Navy and I know how to do it properly, consequently, when a nurse (or an aide) does it and it was done in a sloppy manner I let the doc know. Blood pressure, weight, and pulse are not to be treated lightly.

Doctors are trained to make life and death decisions. I would not want a nurse to be involved with my complete care. The nurse may execute the doctor's orders but rarely is the nurse expected to originate any prescriptions for potentially toxic drugs like narcotics or sedatives. A doctor often sees things that look like something else, therefore, some tests have to be ordered to help make this decision. Nurses can not order these tests.


Also, most care givers, including nurses, do not know what a "sedative" is. The definition of a sedative is..... A drug that produces a state of lessened physical activity. A patient who is sedated and is resting comfortably have their eyes closed, however, this is not sleeping. A sedative in a high dose can be a "hypnotic". Hypnotics are the equivalent of a "knock out" drug. Both classes of drugs can KILL a patient if they also had alcohol. That is because they suppress respiration and other brain functions.


A drunk may come into an Emergency Room very combative and noisy etc. If given a sedative or hypnotic it could kill the patient. Many tranquilizers cause "drowsiness" and this is a sedative. The combination of tranquilizers and alcohol has killed many people.