Verbal Orders -- Yes or No?

Specialties Emergency

Published

Hello everyone!

I've been a telemetry nurse for a little over a year now and have just begun cross-training in the emergency department. One new caveat--doctors giving verbal orders! For example, after telling a doctor that so-and-so has pain, he would say: "Give 1 gram of tylenol!"

With that said, do you put in orders or do you wait for the doctor to put the medications in themselves? What about that situations when the doctor is at the bedside, stating, "Go and grab me this?" With them not being able to put in an order at the computer, do you put it in yourself? Do you feel safe doing this?

The two nurses I've been under have told me to wait until the doctor puts in the order, which I enjoy, because it feels much, much safer!

Sometimes I have noticed that many doctors either lag on putting in orders or just completely forget about it. So far, a lot of the times, I have kindly reminded them, stating, "Oh, hey doc, can you put that order in for so-and-so?" But sometimes when I nag, I feel like I'm being bothersome (but I don't want to make a med error). In my opinion, it should be standard policy that doctors should put in ALL orders, but that's just me. And I know it depends on hospital policy as well.

Thoughts?

Specializes in ICU, trauma.
Hello everyone!

I've been a telemetry nurse for a little over a year now and have just begun cross-training in the emergency department. One new caveat--doctors giving verbal orders! For example, after telling a doctor that so-and-so has pain, he would say: "Give 1 gram of tylenol!"

With that said, do you put in orders or do you wait for the doctor to put the medications in themselves? What about that situations when the doctor is at the bedside, stating, "Go and grab me this?" With them not being able to put in an order at the computer, do you put it in yourself? Do you feel safe doing this?

The two nurses I've been under have told me to wait until the doctor puts in the order, which I enjoy, because it feels much, much safer!

Sometimes I have noticed that many doctors either lag on putting in orders or just completely forget about it. So far, a lot of the times, I have kindly reminded them, stating, "Oh, hey doc, can you put that order in for so-and-so?" But sometimes when I nag, I feel like I'm being bothersome (but I don't want to make a med error). In my opinion, it should be standard policy that doctors should put in ALL orders, but that's just me. And I know it depends on hospital policy as well.

Thoughts?

I understand that my ICU is very different than your ER, but i just put in the orders. All of our docs are really great about putting in their orders during morning rounds. However if i tell our doc pt's potassium was 2.8 and he tells me to replace 60meqs of k i usually throw it in for him. Unless he tells me otherwise or has his computer in front of him with this patient's chart open, i'll do it.

Our intensivists are also not always on unit, especially during night. So we have to call them during the night when they are usually half asleep. I usually just repeat back the order or ask them to repeat it again. it's honestly not that big of a deal. Just verify by reading back the order.

Specializes in ED, Cardiac-step down, tele, med surg.

I put orders into be helpful when they are busy. I like helping my team members out and if the doc is intubating or something I'm not going to wait until they are done. Docs are encouraged to put their own orders in though most of the time.

Our drs are expected to put in their own orders, and we are strongly encouraged to tell them to do it. Sometimes I'll put in verbals, depending on the situation but for the most part our drs are on it and put stuff in right when they need it.

I ask them "are you going to put that in or do you want me to?" Most of the time they will but sometimes they tell me go ahead if they are about to head into a room to see a patient. And if they say they will and just remind them, they get busy and forget.

OP,

I'm in a teaching hospital, our policy is "no verbal orders unless in an emergency." I heard from our senior nurses that they fought hard for this, which is great as it protects the nurses.

When I float to ER/Obs, our Residents/NPs/PAs are great about putting in orders immediately (as in less than 10 sec) when they're not with a patient at the moment.

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