Doctor texting order turned into a nightmare

[Scotthudson1966]

I work in a sub acute care facility and we don't always have a doctor in house. Most of the doctors and nurse practitioners are texting orders to the nurses. We are also texting questions and lab information to the mds and nps.

Today I had a patient with a blood sugar of 600 and paged the doctor and did not get a reply so I texted the doctor And she texted me back stating to get stat labs give additional insulin etc then she proceeded to text orders for three other patients. Med changes and other labs etc. in the middle of her texts she decided to send the patient to the ER after stating to wait for stat labs since the patient was asymptomatic.

Somehow I missed the text send to ER, so when the next shift took over I told the on coming nurse to be on the look out for the stat lab results and call MD as soon as they arrive. The labs arrived and when he called the doctor she flipped out saying she gave orders to send mr X to ER And she told the other nurse she is going to sink my ship so to speak for not following orders.

I'm sure anyone reading this can see so many wrongs here. Thinking from now on no more texting with doctors. Anyone have any similar situation or thoughts on this issue ?

[Nurse SMS, MSN, RN]

Forbidden to send or accept patient info via text at my place of employment and I am glad for it.

[AnonRNC]

OP, does your place of employment support texting, prohibit it, or not say anything about it? If texting is not prohibited, this is a SYSTEM problem, not a matter of what you personally did. It sounds like this is a good opportunity for the facility to get its policies updated.

[netglow, ASN, RN]

NEVER use your personal phone to do healthcare business! OMG NEVER!

[HeartsOpenWide, RN]

We do VORB (which we only try to do in emergencies) and TORB....no text message orders...we once had a midwife on call who asked another nurse to text her when her patient showed up because she was at a movie...simple "your patient is here" no names, that's it. Personally, I would never use my phone for work purposes other than to text my boss non-patient related questions. I would never text any medical info in a text or take an order! I am sure that is so not legal; you AND the doctor are to blame for any mistakes in this situation.

[classicdame, MSN, EdD]

We are not allowed to text orders or ANYTHING pertaining to a patient. MD can call

[FlorenceNtheMachine]

And this is what happens when you give an inch. Because its quicker, convenient, blah blah blah! Our bad habit is doing a telephone/verbal order when the doctor is sitting right there. But because no one will speak up, and ask the doctor to use their own hand to write the order. So the nurses get raked over the coals because we shouldn't be writing out verbals unless its an emergency.

[tjmiller]

I work in a hospital and a clinic. We are not allowed to carry our personal cell phones. We have at times texted one certain Doc who never answers the phone and simply said Please call ASAP. Never would I dream of accepting orders VIA text. The same Doc tried to text orders to me over weekends for things to do on Monday. I was off duty and would not respond. I turned all over to my clinic supervisor and those texting orders stopped immediately! Partly, I think, was do to my spouse telling the clinic they could pay for my cell and give me ovetime pay...

[ksgirl2012]

Yup, serious HIPPA violation.

[limaRN, BSN, RN]

And this is what happens when you give an inch. Because its quicker convenient, blah blah blah! Our bad habit is doing a telephone/verbal order when the doctor is sitting right there. But because no one will speak up, and ask the doctor to use their own hand to write the order. So the nurses get raked over the coals because we shouldn't be writing out verbals unless its an emergency.[/quote']

I just bring the chart to them and say here you go!! Several docs roll their eyes because other nurses take verbal orders but I don't care it's safest.

[leslie :-D]

what does your p&p say about receiving orders?

if it does allow texting, i would encourage DON to re-eval policy.

leslie

[Rhi007]

I doubt it's even a legal way to go about things anyway...what if the pt croaked and the family sued, receiving txt messages for orders wouldn't hold up in court!

[tewdles, RN]

I havent read all of the posts, my apologies if this has been addressed...

How are you protecting the privacy of patients through cell phone text messages???

Texts are NOT secure. IF you are receiving orders you MUST be identifying the patient in the text. You might want to discover the legalities of what you are doing.