A Nurse's Discretion: Can a Nursing Professional Override a Physician's Decision?

By definition, the nursing professional provides hands-on medical care to patients in clinics, medical centers and home-base health-care environments. Additionally, these professionals operate in a diverse range of clinical environments ranging from anesthesiology to emergency pediatric support.

Daily, the registered nurse interacts with physicians or surgical specialists to deliver patient status reports while receiving instructions on the parameters of individual patient care.

This interaction represents the key component in the delivery of treatment for patients who visit a medical center on an ambulatory or walk-in basis in addition to patients undergoing extensive care while admitted to a medical center.

The patient care environment sees the status of each patient fluctuate with the circumstances regarding their medical condition. The registered nurse performs a key role in responding to an acute or emergency development by administering medications or performing the accepted techniques in response to the emergency.

By law, the administration of medication or the performance of any procedure by a registered or licensed practical nurse must be authorized by an attending physician.
This relationship remains the most critical element in preventing malpractice and establishing a solid chain of care in most medical environments.


In the face of these facts, the question remains: When can a nurse override a doctor’s orders or decision?

Simple answer: Never

As mentioned above, legal parameters prevent the registered or licensed practical nurse from performing or ordering a procedure on a patient without authorization from an attending physician. Despite this, many nursing professionals share a relationship of increased trust with their physician colleagues.

This trust often results from close knit realities of a small clinic working environment, or reflects a physician’s confidence in the nurse’s professional competency. That being said, a physician’s trust in a nursing professional’s ability to provide the utmost patient care sees slivers a leeway appear when providing direct patient care.

Of course this leeway remains fully documented on medical reports while the patient family receives a full explanation on each procedure.

Additionally, rare cases emerge where questions regarding the competency or capacity of a physician to perform a task exist. These cases must accompany a chain of events that clearly establishes the nurse’s need to act.

In the case of nurses assigned to a branch of the United States military, the prevalence of the rank structure sees board certified physicians required to follow the lawful orders of higher ranking officers who are in fact, registered nurses by training.

These lawful orders often regard medical care for members of the military or in extreme cases, foreign combatives.

Regardless of the situation, the prospective nursing candidate interested in pursuing registered nurse jobs in California, must remain aware of the parameters of the position, while understanding that the prescribed standard of care must remain intact.