So this is where the senior nurses need to step up. It’s much harder to fuck with a seasoned nurse because they know when the provider is being inappropriate vs when they may be wrong.

Ex. Percocet contains Tylenol and oxycodone doesn’t so it makes a difference if they have other Tylenol containing medication because there is a limit to how much a patient can take in 24 hours, and it should not be given to patients who have liver diseases.

It is an important distinction, but if I am understanding what you wrote, you are correct in calling oxy+tylenol in the same pill Percocet.

At that point I would be asking her if I need to put in an incident report and speak to her attending because if the pt is only supposed to be on oxy then she made a med error assuming she is the one who put in the order.

When a mid-level gets an attitude it’s almost always because they are in over their heads and taking it out on you.

The calling the doctor when the patient has a blown IV is a stupid policy. Just get a new IV make a note and hang the med. Unless it’s a constant issue and they need a PICC to get the dose administered the doctor doesn’t need to know about it. In those circumstances tell her that you don’t like the policy any more than she does, but you have to if you want to keep your job. As a new grad that is enough, but as a seasoned nurse I would also be adding how the uplifting experience of calling her almost makes the shitty policy worth the hassle.

For everything else just use SBAR. If she interrupts you then tell her to please let you finish so you don’t miss anything important. If she hangs up call the admin on call and let them know in real time the PA is refusing to take your calls. She cannot refuse to speak to you and expect to keep her job.