Telephone Orders- Perplexed in MA!

  1. My first post :smilecoffeecup:

    I work in the acute care setting, in the Float Pool, and this is my kerfluffle with posting telephone orders.

    A nurse working on the unit with me came over to me and said "can you post these for me"; it was a fairly long set of telephone orders that SHE had taken- she wanted me to post and sign off on them.
    I asked around, and a lot of the other nurses do the same thing- they take telephone orders and have another nurse post and sign off on them. The nurse signing off the orders does not hear the phone call from either end.
    The nurse who takes the orders does NOT sign off or post them, just their sig after the MD's name and the T.O.


    Now, am I being too AR or what, to my way of thinking (as well as how I was taught) why would I want to sign off and post something that I never heard??? To me, that says I witnessed it.

    My mind's in a muddle. LOL

    I hope everyone is having a great weekend. I am working :smilecoffeeIlovecof


    Kathy
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  2. 24 Comments

  3. by   TooterIA
    We do this in my facility only if there is a reason the nurse who took the phone call cant write them herself (she is busy and cannot sit to write them, or an emergency happens). Otherwise, each nurse is expected to write the orders they took. But I have written orders for another nurse before, just put their signature in front of mine
    Jessica
  4. by   RN and Mommy
    Quote from TooterIA
    We do this in my facility only if there is a reason the nurse who took the phone call cant write them herself (she is busy and cannot sit to write them, or an emergency happens). Otherwise, each nurse is expected to write the orders they took. But I have written orders for another nurse before, just put their signature in front of mine
    Jessica
    I wouldn't feel comfortable writing orders for an other nurse. I didn't hear the orders and I wouldn't sign my name after them.
  5. by   Nurse Crystal
    i think that if a nurse takes orders from a doc then he/she is responsible for transcribing them and noting them off. if that particular nurse is really busy then she needs to come back when she is free and put the orders in the chart. the only way that i would transcribe someone else's orders is if i knew i could trust them.
  6. by   Jay-Jay
    I certainly do not feel this is a safe practise. If you didn't personally take the order, you have no business signing your name to it. Just think of the consequences if the transcriber made a mistake...it's YOUR license on the line for his/her mistake!
  7. by   SCRN1
    I wouldn't do it. Your signature means you took the order from the doctor. If there is a mistake, it's YOUR job or license on the line. Not the one who took the order and didn't sign it. Should something ever go to court, what do you think they're going to say if you tell them you didn't take the order, the other nurse did & you were only signing off on it? The opposing lawyer will eat you alive. Same principle as "if it's not charted, it wasn't done", only in reverse. Another thing I would hate to think would happen...what if someone decides to set you up and falsely writes an order & asks you to sign it just to get you in trouble?
  8. by   AfloydRN
    Think of the legalities.... Our policy is if you hear them you write them. You can refuse. What if she misunderstood a med or the dose?
  9. by   Roy Fokker
    Quote from Sabrina's Mommy
    I didn't hear the orders and I wouldn't sign my name after them.
    Ditto that! If a co-worker wanted, I'd WRITE them down and leave it for them to sign.

    No way am I signing for stuff I didn't do/see/hear/witness!
  10. by   gonzo1
    no matter how busy we are, we have to do the orders we take on the phone. No one else can do this for us. For all the reasons stated by above posters.
  11. by   neneRN
    I wouldn't write them for another nurse unless there was some emergent reason she couldn't do it, and then in that case I would either not sign the orders (let her sign her name when able) OR (if it was a nurse I knew well and trusted), I would print her name and sign my name behind it.
  12. by   kathybMA
    Thank you!!

    For the life of me, I couldn't understand why anyone would do this... it just seemed SO common sense to me NOT to sign anything I haven't personally witnessed/done.

    I have been steadfastly refusing to sign such orders, and get such responses as "don't you trust me?" and "everyone else does it".

    I'm going to talk to my boss and pursue this further as I am getting a lot more requests to do this the last couple of weeks

    Thanks!! for your input- I appreciate it!

    Kathy
  13. by   Inquisitive one
    This happens frequently in the LTC facility I work in. When a nurse takes a telephone order she writes it on the Doctor's order sheet with TORB(telephone order read back) DR. XYZ/Nancy Nurse RN. This nurse may or may not have time to note and post the order d/t end shift, emergency etc. so the nurse who actually puts the order onto the MAR or Treatment sheet , orders the lab or whatever, writes noted and posted with her name and title on the line below the TORB line. Of course the nurse noting and posting the order should be able to determine if the order is "safe" before posting it and question any order that she feels uncomfortable with. What's the practice where you work and has this practice ever come back to bite anyone?
  14. by   CaLLaCoDe
    Sounds like risky business; and I wouldn't agree to putting the orders in the computer and noting them, no way!

    My other gripe is having a physician write "check peak and troph on vanco" and the results come back high 20.6 ^

    So you call the doctor and the doctor says, "You know you don't have to call me, just put the vanco on hold till and wait for future orders."

    NOW, isn't that an order! It's my license not hers!

    And she is rude and hangs up on me! Now I feel like calling her at three a.m. tomorrow for an ingrown toenail to be swabbed for fungal infection?!:angryfire :angryfire :angryfire
    Last edit by CaLLaCoDe on Feb 4, '07

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