"When it comes to actually adapting medication, you could lose your license," Gary says. And she's certainly not advocating for "willy-nilly" rule-breaking; nurses need to have enough clinical knowhow to know when it's appropriate to bend the rules. Besides, Gary isn't talking about nurses who are going crazily rogue, like Dr. Gregory House on "House, M.D."
"This is not the dark side of nursing," Gary says. "Nurses are doing this to provide patient-centered care."
Gary acknowledges that nurse managers have to walk a very fine line here; they don't want to blithely encourage rule-breaking, after all. But instead of rigidly following black-and-white rules, Gary says nurse leaders could perhaps be more open-minded and find a balance between a strict policy and something that's more of a guideline. Doing so would allow for the complexity of healthcare and also trust nurses to act in the patient's best interest.
"I'm not exactly asking for nurses to have more autonomy, just knowing that they can be more accountable for the care they provide," Gary says. Nurses want better guidelines to help "guide their care but not dictate it."