[HappyNurse2005]

we just have "verbal order" and have to signify read back. i think this is a jcaho thing, yes?
something like
admit to labor and delivery. routine labor orders
VO Dr. XXXX/RB Happy Nurse, RN
(with date and time of course)

then, they get a little green sticker underneath for them to sign/date at a later time, acknowledging that they did actually give the verbal order. this isn't a new sticker thing, but for a while we were diong the verbal order without the confirmation sticker, so they havne't always been hand in hand.

verbal orders and telephone orders handled the same.

[Rnandsoccermom]

The hospital I work at is 100% computerized, no paper. We have been doing this as well, difficult to ascertain verbal vs. T.O. since all SPOKEN orders are verbal orders. We have a prompt on the screen that the order was read back to the MD, and a prompt to differentiate verbal or T.O. I always put verbal, that's what it was, a spoken order.

[clee1]

I probably take 1-2 dozen TO/VO's a night.

TO/VO Dr. XXXXXX
Medication 2mg IV q4h prn pain
RBAC/Dr. XXXXXX/Me, LPN

Have had zero problems as yet, and only once have I asked the charge to verify the order (a cardizem IVP order).

[allantiques4me]

We were taught to do that in nursing school.Some places try to have you deviate from safe practice.Always remember what you learned in school and safety first.

[Spatialized]

I've taken VOs in emerging situations, but gave the MD the chart right after saying, "Can you write that for me?" As a night shifter, while we have house officers in-house all night, they cover the entire hospital and do all the admits from ER to the floors. 9 out of 10 times, they're nowhere near the floor so TOs are the orders I usually get. For med and lab orders, there is a box to signify what kind of order it is when we enter, it then pops up on the MD's profile for them to sign (in case of a TO) when they log back on. So it is written, at least by me, and I always read it back, to make sure we both have it right.

When I worked in LTC, I took TOs on weekends in cases where the orders needed were not already standing/pre-printed orders. I t worked then as well.

Cheers,
Tom

[Roy Fokker]

VO/TO?

No Doc on the floor gives us VOs - except for the ones who've been here 30+ years and are used to doing so (and management doesn't pressure them to mend ways). I have a habit of writing VOs down on scrap paper (just in case) while I bring over a Physician Order sheet for the Doc to write it down on.

Sometimes, when I've been too busy, on occasion I re-copy the VO and write it down as a TO.

I apologize if this has been addressed earlier, but I just had to share my thoughts:

Originally Posted by kittagirl

Or what if the patient needs an ice pack or heating pad for comfort?
Why would I need Dr to prescribe that? That would be a nursing decision.

Perhaps this is simply difference in practice between US/UK, but here:

If I put a heating pad on a surgical patient (say an abd. hysterectomy) without a doc's order, there'd be heck to pay! Sometimes, something that may seem very "routine" (e.g. Ice pack on fresh post op joint replacements) can lead to trouble if done without doc's approval.


Many (if not most) treatments require a doctor's order to be implemented. Luckily, we work with a fantastic bunch of Docs (80%) of the time - they trust our judgment in regards to many things.


cheers,

[P_RN]

Our hospital got sued for like a bajillion $$ for a severe burn from a heating pad, therefore NO heating pads.

I sure wish our orders had been computerized. We had a couple of doctors who couldn't write worth a darn and it was terrible to try to interpret.

As far as verbal orders, I had more than one go-round with this one doc who coulnd't understand why we couldn't honor orders he called in from Bolivia, Grand Canyon river rafting, London Gatwick etc. He was a nice guy but sheesh.........he was also one who wrote like a drunken duck.

[BittyBabyGrower]

No verbal orders unless it is in an emergency, we rarely have TO as we have residents around all the time.

[DEB52]

Thanks for letting me know that we are not the only one's doing this. When I was at work yesterday ,I heard that the residents were calling nurses on the phone from down the hall to give them to orders so they didn't have to write them. I think this is going to be a long and hard transition for all. Even the nurses are complaining about the change. They don't seem to get it that's it's their license on the line.

[HelenofOz]

As I work in Recovery verbal orders are not an issue-the anaesthetist is there so he's writing.

For phone orders in New South Wales the Health Department regulations state that the phone order can be received by a pharmacist, medical officer or registered nurse and then read back by that person, and then another person is to also hear & read back the order. It is recorded in the appropriate area of the chart set aside for phone orders and signed by both people taking the order, and the original prescriber is to sign within 24 hours.

We have a career M.O. on site 24 hours and in this case he/she would have contacted the surgeon or anaesthetist for orders for treatment where an issue arose.