Report without Orders?

  1. 1
    Is anyone else expected to routinely take report and accept a pt from the ER with out seeing the admitting orders?

    I just transferred from med surg to the icu; and I'm now forced to routinely take report on pts without the ER sending me the order. The med surg floor that I came from insisted that the orders be faxed before report was given and maintaining that prevented a lot of problems from ever reaching the floor or the pt. It seems kind of dangerous to me, but I was wondering what you guys think.

    Thanks
    netglow likes this.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 28 Comments...

  3. 0
    and how would you know what to do with the patient without orders?

    We have a form that the ER nurse faxes to the floor that passes as a report. They may also choose to fax the MD orders at the same time. Then, the receiving nurse has the option to call ER after getting report to clarify any issues. As you know, sometimes the two nurses play phone tag, so the faxed report and orders do help us with admits.
  4. 1
    Where I work the floors don't get the orders prior to report, there are times when there aren't even orders written yet when the patient is transferred. In ICU, the patient is transferred without orders being written yet about 1/3 to 1/2 the time. We're a long way from having orders in your hand when you get report, although it would be nice.
    xtxrn likes this.
  5. 0
    Quote from missbutton
    Is anyone else expected to routinely take report and accept a pt from the ER with out seeing the admitting orders?

    I just transferred from med surg to the icu; and I'm now forced to routinely take report on pts without the ER sending me the order. The med surg floor that I came from insisted that the orders be faxed before report was given and maintaining that prevented a lot of problems from ever reaching the floor or the pt. It seems kind of dangerous to me, but I was wondering what you guys think.

    Thanks
    Other than getting a verbal phone report from the ER, I never got orders 'tubed' (older days) or faxed before seeing the patient. Never. You got report- then got the patient. If lucky, the reporting nurse would tell me of anything weird- otherwise, it was just expect the standard orders for that patient (and if practical, have stuff ready), and know that with an admit, you just never know until you get them.......
  6. 0
    Quote from MunoRN
    Where I work the floors don't get the orders prior to report, there are times when there aren't even orders written yet when the patient is transferred. In ICU, the patient is transferred without orders being written yet about 1/3 to 1/2 the time. We're a long way from having orders in your hand when you get report, although it would be nice.
    Same situation in my hospital MunoRN. Sometimes the ER doc will write an order to admit to "Dr. So-and-so, he is aware of admission" and "Dr. So-and-so will assess pt in am."
  7. 0
    we don't get orders 85% of the time, down in the er it is decided whether or not to admit the patient to hospital on a form they fill out it is obs or inpatient. but orders rarely unless the patient needs to go right to surgery, then there may be orders already and sometimes not, sometimes the doc comes up right away because the hospitalist was informed we need clearance, but usually we get a faxed report from the ED and then when the patient gets to the floor we call the admitting doc, let them know they arrived to the floor to the admitting paperwork that needs to be done for all patients regardless of their admitting status and hope the doc gets there soon
  8. 0
    Quote from classicdame
    and how would you know what to do with the patient without orders?

    .
    We had to call the doc when the patient got there, and after doing a brief assessment, to get questions lined up for the doc in one call.. the ER doc had already seen them, so it wasn't like they were walking in cold...(well, some were a bit chilly )
  9. 1
    I will take report from an ER on a pending patient without having orders yet; however the patient can not be admitted to my unit without orders.
    Katie5 likes this.
  10. 0
    We only get a SBAR form faxed up to us from the ED when the patient is on their way up. Tells us chief complaint, most recent vitals, IV site, and usually that's about it.

    Protocol states that no patient may be admitted to a floor without (at least) interim orders, but a number of them are. Always the same offenders; docs that want the admission but don't want to be paged for orders in the middle of the night. With the others, we don't get a peek at the orders (labs, fluids, tests, etc) until the patient arrives. Makes your heart beat a little faster to not know what's en route, that's for sure.
  11. 0
    I didn't realize that that's the way it is at other hospitals. In my defense, the orders are the only official notice that we get, its the only thing that even has the pt's name and DOB. Thanks for sharing.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top