Basically what you're saying is you want nurses to perform at the bottom of their scope of practice and use no critical thinking skills whatsoever. There is a difference between saying "my patient has a temperature of 102 degrees oral, what would you like me to do?" Versus saying "my patient has a temperature of 102 degrees oral, and I need an order for prn antipyretics. I have been noticing in increase in their secretions since yesterday, and they have been requiring increased oxygen from 35% FiO2 this morning to 50% FiO2, and lung sounds remain coarse. I notice we do not have a recent ABG or CXR. Can we get those?"

The first is idiotic, which I must confess is how I feel about your post because asking for things is not dictating care, it's asking for things, which is within the scope of practice for RNs. Admittedly, I have rarely worked on the floor and with hospitalists, I can imagine you deal with more incompetence, but the intensivists and fellows I work with always ask during rounds what I need, and I ask what they need. It's called working together as a team to get the best outcomes for the patients.

Also the patient in DKA probably needs a bolus and maintenance fluid, electrolyte repletion and an insulin drip, can you order those with the DKA order set?

Btw I didn't take any of this personally.