Doctor texting order turned into a nightmare
- 0Feb 14, '13 by Scotthudson1966I 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 ?Last edit by Joe V on Feb 20, '13 : Reason: spacing
- 3Feb 14, '13 by RNewbieIs it even legal? I thought orders were written, telephone, or verbal. I worked at a facility where we could alpha page the docs with a message about what the issue is. They would call back to give orders. Texting orders sounds like it could work but not through someone's personal phone. Too many things can go wrong. Maybe if there were special phones used or if someone was responsible for checking the phones for any new orders.
If the docs have time to text back couldn't they just call?
- 1Feb 14, '13 by edmiaYou paged the doctor and she did not answer the page. If she's making trouble it is only because she messed up. You texted her because she did not respond via the approved communication method and you had a patient who needed orders immediately.
A lot if systems are wrong here, including no protocols in place to handle such a situation . Don't let the doctor throw you under the bus when you were left without the resources to manage your patient.
Tell them that from now on, if a patient has a crisis and the MDs don't respond to pages and you have no protocols or standing orders to deal with the issue, you will call 911 and send patient to the ED.
Sent from my iPhone using allnurses.com
- 3Feb 14, '13 by madwife2002, BSN, RN Senior ModeratorI have texted my MD because he always answers his texts and we get a very quick response to what we need. Sometimes I just text call me!
It honestly depends on the situation and how it is managed!
Also I have proof that I did contact the MD, at what time and what he said or did
I love using my cell phone to call the Doctors rather than the unit phone as I am able to look back and establish a very accurate time line!
It helps with my documentation
- 7Feb 14, '13 by madwife2002, BSN, RN Senior ModeratorText messages are discoverable in a court of law and are being used frequently as supportable evidence.
If you use this form of communication, then you need to take responsibility for it, remember it is very hard to dispute the written word.
- 8Feb 14, '13 by iluvivtThe Joint Commission stated in 2010 that texting for the MD/LP orders is not an acceptable practice in all healthcare setting.
This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record,
Read-back is impossible in a text message, you have no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered in the medical record.
- 4Feb 14, '13 by blondy2061h, MSN, RNUnencrypted text messages, like those on cell phones, are a HIPAA violation. I also agree with the person that said he's likely worried his butt is on the line for not answering a page. Why was the patient being sent to the ER for being asymptomatic?