Taking orders over phone from unlicensed . . .

[st4304]

I was just reading another post (But she's NOT a nurse!), which made me remember an incident that happened a couple of years ago.

I called critical labs to a family practice physician at his office for one of his hospitalized patients and had to give the results to one of his medical assistants (he does not employ any licensed nurses). A few minutes later, the medical assistant returns to the phone and tries to give me his orders. I informed her I could not take orders from her over the phone, I have to receive them from him. When she told him I was refusing, he got on the phone and we had a very terse conversation regarding the above. His opinion was that his medical assistants were nurses and, I quote, "A nurse is a nurse to me, I don't care what initials are behind her name." I informed him the state's nursing practice act but he still b*tched at me.

Has this ever happened to anyone else?

Your pal,

Sherri

[rdhdnrs]

That's when you get a new doctor!!!

[austin heart, BSN, RN]

does anyone know a good web site for checking leagal duties and practices of ma's in the state of texas?

[deespoohbear]

I can understand not taking telephone orders over the phone from someone other than a MD, but NO telephone orders at all? The first time I have to tell a doctor that I can't take a telephone order for something at 2 am and I get my butt chewed I plan to have the JCHAO surveyor's phone available and put the doc through to him/her. Let's live in the real world folks. At our small county hospital we usually just see our family docs first thing in the morning and that is it. The rest of the day we communicate through the office, or with the doctor directly. I doubt if any of our family docs are going to want to leave their busy offices at 2 pm to come to the hospital to write a flippin Tylenol order! The people at JCAHO have waaaaayyyy toooooooo much time on their hands! Maybe some of them should come out to the "real" world and work about 3 months under their own stupid rules. They wouldn't last one shift. Oh, this has really got me fired up!! :(

PS- I was wondering does anyone have any links about JCAHO and the telephone orders. I sure would like to see it. Thanks.

[nursegoodguy]

YES! Same exact thing! I feel bad for the patients that have the docs that don't want to come to the phone! On the other hand I also was on the phone to a practitioner and five minutes later the PT-A wanted an order for therapy for a patient... I said, I just talked to them and I am not calling back until later... Then the patient in question came to me asking and I told her the same thing! While she was complaining about me to administration the doc called and I got the order since it was convenient for them to give it. I am not calling them for something that could wait just in case I get a few more things to add to the list unless it is an emergency or something to do with pain!

[Ted]

My wife works for a local gastroenterologist as a medical transcriptionist and billing person.

The stories I've heard from her mouth! It's scary!

Sad to say, she works for a totally dysfunctional office for a totally dysfunctional physician. Let's just say, office help (one person in particular) with barely a high school education are/is handing out drug samples, receiving and giving verbal orders for medications and test procedures, and even providing medical advice . . . all without this physician's awareness!!!

There's a huge law suit and/or criminal suit just waiting to happen!!! He could and probably should loose his Medical liciense!

The office manager knows what's going on, too! She's "desciplined" the office help who do these things. Still they're being done! There's no real accountability . . . anywhere!

I'd love my wife to quit her job. She works at home doing the transcriptions and billing work through our computer. So, she wants to hold on to her position. I wish she wouldn't!!!

The sad part is that this physician is great in diagnosing! He's caught many-a-cancer for many-a-patient! He's much more aggressive than most physicians in ordering tests. He's aware of what goes on in his office, but doesn't seem to care.

I'd NEVER take a verbal order from anyone without an M.D. (or NP!) after their name!!!

And if a physician thinks a "nurse is a nurse" despite not having ANY proper and legal credentials . . . and allows "medical staff" to give and/or receive orders . . . . should be FIRED!!! He/she should be reported to the medical board and stripped of thier ability to practice medicine. . . and jailed for fraud.

Ted

[psychonurse]

This will really mess up lots of places I can't believe that a governing board would let it get this far. I mean I don't know how many orders that I took over the phone when the doctors weren't in the hospital and the calls at night!!!!!!! Glad that corrections isn't governed by the the JCAHO cause we don't even see the practitioners from Friday evening until Monday morning..and you can be sure that they get called......

[CaliNurse]

At my facility we only take first hand orders..... ok thats our policy. In reality most of us (not me) take orders from who ever calls us back. Second hand orders I have been told are illegal.... never have seen it in legal script.

I once reported to the doctors office that a patient was developing a red coccyx and we would like to use a duoderm. She said "oh, yeah that should be fine". I ask her to report this skin condition to the doctor and she said its just an order for dressings.

I informed her ( the receptionist ) that its was illegal for her to give orders and I can not even write them in the chart.

The medical staff office really needs to tackle these issues with the docs. We will be fine tuning this for years.

Cali

[Mama Val, ASN, RN]

When I worked in Kentucky our unit clerk would get the orders from the doctor then write them in the chart then we were supposed to take them off and do the PX, TX, give the med, etc..

How were we to know if that was the way the doc really wanted it until they showed up later or the next day or on Monday and remembered to sign off orders. Our clerk was good and knew enough to ask questions if it didn't sound right.

My old nursing supervisor (she has since moved on) where I work at now was a trip. She would take an order over the phone write it on a sticky note and then give you the note, sometimes with the patients chart and say "Here you need to do this order". Either take the order off yourself the correct way or give me the phone and just let me do it. One of the other nurses I work with got so fed up she started taping the sticky notes in the chart and made it part of the record, then took the order off from the sticky note.