Doctor's lying about telephone order

Nurses General Nursing

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I an very upset, mad, devastated, anxious and depressed. I received a TORB from a doctor for 10 mg or medication to be given once. 4 days later patient developed EPS (which is kind of strange because EPS would develop on second day not after 4 days.) I am suspecting that the patient was getting a "nursing dose" of the medication because no orders were documented 4 days after the shot he received from me. Any way.... the patient had EPS, mom got upset and started complaining. The doctor told the administration that I must be written up because he only ordered 5 mg. I would admit there is a small chance that I misheard the order ( it was busy on the unit that day) BUT he also told them that I suggested to give higher dose and asked him 3 times : " Are you sure you want to give such a small dose?" Later he told another nurse that I kept insisting on giving patient higher dose and , according to him" I gave higher dose despite his order of 5 mg. I do not recall him giving order for 5 mg and I know for SURE I never questioned his order, never insisted of higher dose. Such conversation NEVER happened between us. It was short and sweet: "Pt such as such does this and this. What can we get? Thank you, Bye! He is demanding to write me up. The management stated that they believe me but I am bitter about fact that the doctor can just throw you under the bus and there is NOTHING you can do. I called him and he got all defensive claiming I questioned the dose 3 times which is a big fat lie. he told me that ' everybody in the world can confirm I was insisting higher dose. I asked : "Who are those " everybody"? He said its his wife. Yaah... very unbiased witness....Uninterested party..... I never questioned his order. I was told not to confront the doctor and basically it was all swiped under the rug which is ok with me but I am fearful for my future. We are not allowed to record phone conversations with doctors and its is unrealistic to always have another nurse to witness the phone conversation especially when we have emergency situations requiring immediate call. In fact, we have another doctor, who is known for refusing her orders with multiple nurses....and no disciplinary actions are taken against her. Basically a doctor can very confidently give any order and than " hang it "on the nurse. How do I protect myself from this ever happening again??? This case really gives me depression ,anxiety and feeling of hopelessness.

Totally despise telephone orders.

Chances of miscommunication, especially when both parties have an accent :D. This person said/that person said... bleh.

It would be nice if more facilities make it a point to have a witness sign off on telephone orders and/or record conversations with telephone orders.

Mom made a big deal over this incident and was threatening to sue. I doubt the EPS was from my shot. because it developed four days later.

It wasn't an adult dose. We routinely give 10 to adolescents. Pt. just developed EPS, things happen. But the Dr. decided to put this on me . Thank you for support. I am starting to forget about it.

I agree. Writing a note about receiving an order wouldn't help at all. The only thing that could help is a witness. I am waiting for RN who was near by that day. She is currently on vacation. However, as you already suggested I would probably just move on. Thank you everybody for your opinions and support. I am slowly letting it go. On the other hand, I still can't accept that nothing is done about it: " Oh... this doctor.... we know... don't worry.... he does that sometimes....." He does that sometimes?????????? *****??????? How about some disciplinary actions for "doing that sometimes"???????

BTW, very interesting fact: he actually DID sing the order!!!! How does this make ANY sense???????? I think he signed the order then he was notified that patient is not ok and decided that the order is wrong .....

Specializes in Gerontology, Med surg, Home Health.

EPS take a while to manifest. I've never heard of an EPS on day 2 or 3 of an antipsychotic.

Hummmmm ..... strange it happens though ,. Thank God u were not written up.

Specializes in EMS, LTC, Sub-acute Rehab.

I don't know about anyone else but I tend to check the chart and the drug book after receiving an order. I've caught physicians Rx'ing drugs to people with known allergies, wrong dosage, and incorrect or non-existent parameters. If something exceeds the recommended dosage, I'll call pharmacy to confirm. If necessary, I'll hold the drug until I get clarification from the Doc via text. I'll type out all of the information so it's a yes or no response and then save it.

I rarely do TO unless it's really an emergency. We haven't implemented a real EMR or E-scripts according to the CMS mandate anway. It's like working in a 1980's time capsule. Everything is paper and fax otherwise.

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