should MD and Nurse phone orders and phone reports be voice recorded?

[dutchgirl123]

I sat in on another Pharmacy and Therapeutics meeting in our hospital. I listened to the MDs complain (once again) about the calls they receive from nurses, pharmacists and techs re: clarifying orders that were written illegibly or in an unsafe manner. For example "resume all pre-op meds". Also, they are also having difficulty with nurses refusal to take verbal orders. And they don't like the telephone order protocol either (because they don't have time for all that "nonsense".

The Director of Nursing Practice, and the Chief Pharmacist ONCE AGAIN relayed to the doctors that the staff have specific guidelines to follow if the orders are written in an unacceptable manner. And they also mentioned to the docs AGAIN, that nurses and pharmacists are NOT doctors and we cannot do this for them. After the physicians left the meeting, the remaining pharmacists, nurses, resp therapists had (AGAIN) a discussion about the physician's non-compliance and laissez-faire attitude in this matter, which causes a lot of work for everyone else.

Of course included in the discussion was the manner in which the physician attitude is frequently relayed to the person seeking the doctors counsel. And the attitude is often fairly UNPLEASANT and in some cases abusive.

SO...... why aren't we handling all patient related conversations on special lines to record, or convert to text, and time and date stamp these crucial communications? A lot of other less crucial businesses do it.

I believe hospital nurses and pharmacists and therapists taking these orders need this protection. And the PATIENT needs protection from me, possibly writing the wrong order. (because i'm NOT a doctor!)

Why do we continue to take the blame, abuses, and secretarial duties dished out by doctors, without demanding some action? We should have ALL of these communications recorded by a third party electronic device.

Perhaps there would be no more "he said, she said"...because we all know who wins that argument....

[wooh, BSN, RN]

This is why we need physician order entry. Then everyone would be able to read the orders and the mds will not be constantly called to clarify the obscure and hard to read. Of course when they tried to do this at my hospital the mds refused stating that they did not go to med school to be a secretary. They were not hearing anything about patient safety or efficiency.

Hehe, we went to it and were only going to take verbal/telephone orders in "extreme cases" such as MD is driving or scrubbed in doing surgery. Bwahahaha! That's still the policy, so if something happens, they can blame the nurse for not "making" the MD put the order in, but the couple of times I tried to enforce it, I actually got in trouble for "not being a team player" or in other words, "not doing the MDs' jobs for them."

If an MD wants to be an a$$, they're going to be an a$$. It doesn't matter what system is in play. As long as they bring money "in" and nurses are just a huge red mark on the hospital balance sheet, hospitals are going to cater to the MDs.

[merlee]

In this electronic age, unless the MD is unable to type, like if s/he is driving, or during a procedure, there is almost no excuse for giving verbal orders. We can work around HIPAA by using medical record numbers, and everything can be delivered via text.

Years ago, all verbal orders were listened to by 2 nurses, and signed by both of them, to avoid the nonsense of "That wasn't what I said". Too many nurses got caught in the crossfire when a doc would say that no one called him, he couldn't remember saying it, etc., etc.

If no one can understand the scrawl then the doc should be called every time his handwriting is illegible.

Thank Heavens for total computerized charting!

[N.U.R.S.E.]

Good idea if there were on ten meds to record make them type them print or take a handwriting class once again hospital administrators need to back the nurses good handriting clear order4s keep the lawyers away once again all about the documentation

[nyrn5125]

We only have handwritten orders and will always call the md to clarify their illegible handwriting. Unfortunately it is too frequent since there are no computer entry orders. It amazes me how it's always the same ones. When they get annoyed I tell them that no one including pharmacy could read what you wrote and it's not getting dispensed til it's legible.