At the hospital I work at, it is common for a group of Dr.'s to write in the orders "variance report regarding fill in the blank." I've never worked at any other hospital so therefore, I do not know if this is a common practice for Dr.'s at other hospitals. I'm not debating the fact that in most scenarios a variance report is warranted. I learned in school that variance reports are not part of the medical record, and it should not be mentioned anywhere in the notes. If it is mentioned in the med record, it can then be admissable in court. Anytime I have one of these variance report orders, I write on the variance report the required pt info and in the description of events section, I write -- Today, Dr. Soandso wrote the following order, "Variance report regarding blah, blah, blah." (I write the order exactly as it was written.) I turn the report over to my nurse manager, and I let her handle it from there. I've never been reprimanded for this by nurse manager. We get these orders frequently. Thankfully, I've never made a mistake that led to being written up.
I find it especially troubling that the group of Dr.'s who write these orders have been on the local news compaining about our facility because they want seats on the board of directors but the hospital won't allow it. This group of Dr.'s also own a one-day surgical hospital that competes with our non-profit hospital.