I am an experienced RN with 15 years experience but I am new to hospice nursing. I just completed a 2 1/2 week orientation when I had a sticky note on my desk stating one of my patients needed pain medication. I looked through the chart and there were no orders for pain meds. I ask my PCC what pain medication is appropriate and is asked if there is a standing order for any pain meds. The only standing order we have for pain in Ibuprofen and Tylenol. Without consulting a doctor she stated write a verbal order for lortab and call it in to the pharmacy. Is this acceptable practice in hospice nursing? We have two medical directors but the only time I see them is for team meetings and orders are signed then and sometimes taken to their office to be signed. I was just not comfortable writing a physician order without him knowing. Any suggestions?