We have this med order

[GLORIAmunchkin72]

It has been on the MAR to be given BID routinely for 2 months now. The recipient's husband is not in agreement with the doctor's order and demanded that it be given in the morning only. The nurses have tried to get the doc to change the order but unsuccessfully. The only thing to indicate to us that we are to accommodate the husband's wishes is a little "sticky" on the MAR. A little piece of paper can fall off at any given time. We have to constantly circle our initials and chart on the back of the MAR the husband's request. This can get tiring and we have a lot of meds to give. Believe it or not this is not the only med that's supposed to be given routinely and ends up being given just whenever the family wants.(??????):stone

[dbsn00]

The nurse manager/DON should be informed & call the doc for the reason he won't D/C the med, the social worker should call the husband & schedule a family care plan meeting ASAP. If the patient is refusing the med it's one thing. Nurses follow the MD's orders, not "sticky" orders from families, has this been explained to the son & why doesn't the son just call the MD himself & speak with the MD personally about getting the med D/C'd? Oh yes, & as above poster said, chart what husband says whenever coming to the facility.

[RN4NICU, LPN, LVN]

I also am curious why the doc won't change it??? What a hassle to have to document daily refusal.

The doc has to cover his backside, just like the nurses. If BID is the recommended and appropriate dosage, but the doc orders it differently to suit someone's fancy, it is the doc who is responsible if the desired effect of the med is not attained - because it is the doc that ordered it that way. However, if the doc orders the med at the appropriate dosage and interval, but the patient (or her husband) refuse to comply with the regime, it is then a noncompliance issue (patient/husband's fault) rather than a malpractice (doctor's fault) issue.

[CoffeeRTC, BSN, RN]

Not that it matters.....whats the med?

[sharann, BSN, RN]

I think you are doing all you can unless there really IS a valid reason for the husband refusing. If it is a pain med, is he refusing because it makes her too groggy in the am? If so, this needs to be adressed. Does she NEED this med BID really? Can the dose be adjusted to once? I personally would like to know what the med is as well. As mentioned above, if the med is refused by the husband this is ok as long as he has DPOA.

[allamericangirl]

I think that the doctor's attorney would argue with that point. The doctor's responsibility is to his patient who is depending on him/her for the best medical care he/she can provide.

"the doc has two responsabilites on the prescription:

the illness people.

the comunity."

All medical care is expensive. Are you saying that Pts who are getting their medical care paid for by Medicare, Medicade, or some other subsidized med care that these Pts should have proper medical care withheld because of the cost to the community?

"Many drugs are very expensive, society must administrate its resources; doc and nurses are in this way civil servants and must care not only the illness people. The comunity is important."

alanpe, I am curious to know. Are you working as a nursing entity in the U.S.? Are you working in Spain? Are you a nurse? What you suggest is illegal in the US.

No med order is today a big problem.

Thanks to internet and new technologies many patients can learn about his pathology more than a doc; the doc has two responsabilites on the prescription:

the illness people.

the comunity.

Many drugs are very expensive, society must administrate its resources; doc and nurses are in this way civil servants and must care not only the illness people. The comunity is important.

[alanpe]

I think that the doctor's attorney would argue with that point. The doctor's responsibility is to his patient who is depending on him/her for the best medical care he/she can provide.

"the doc has two responsabilites on the prescription:

the illness people.

the comunity."

All medical care is expensive. Are you saying that Pts who are getting their medical care paid for by Medicare, Medicade, or some other subsidized med care that these Pts should have proper medical care withheld because of the cost to the community?

"Many drugs are very expensive, society must administrate its resources; doc and nurses are in this way civil servants and must care not only the illness people. The comunity is important."

alanpe, I am curious to know. Are you working as a nursing entity in the U.S.? Are you working in Spain? Are you a nurse? What you suggest is illegal in the US.

What is illegal in USA is illegal in Spanish Kingdon most of the time, thought not always, even the Constitution; you will know meds and resources are created in USA, after that these resources are copied (imported).

The instructions are in English language, good books are in english, to be a good profesional is good to learn English. Really USA is today the driver that actually move the world. What is not copied doesn´t work here, yes I have seen it; a professional with not English literaty is not a professional.

I work in a spanish hospital as nurse and I study IT in a British University from internet, I consult pubmed, I read law news ..., as you can figure and guess we are not many differents, perhaps we are just equall

[suzanne4, RN]

No med order is today a big problem.

Thanks to internet and new technologies many patients can learn about his pathology more than a doc; the doc has two responsabilites on the prescription:

the illness people.

the comunity.

Many drugs are very expensive, society must administrate its resources; doc and nurses are in this way civil servants and must care not only the illness people. The comunity is important.

In the US, medication orders are extremely important. Nurses and physicians have lost their licenses to practice over these. A major problem where errors accur in caring for patients is with medication administration.

Sorry, but I do not agree with your views.

[alanpe]

in the us, medication orders are extremely important. nurses and physicians have lost their licenses to practice over these. a major problem where errors accur in caring for patients is with medication administration.

sorry, but i do not agree with your views.

we can not decide many times, we must follow the order. almost time the orders.

this is not my view, it is just the law point and i am just one looking the best for all; as you said "nurses and physicians have lost their licenses to practice over these"

mi best wishes for you