Assigned to discontinue treatments not in place. Help!

[ets53]

I work in a long term care facility. My DON has assigned me to write telephone orders to discontinue treatments that are ordered but we aren't doing. Examples are padded bed rails, ted hose, gel cushion to chair.

Also, I am to discontinue orders that legally don't need a doctor's order. For example: Iris mattress to prevent skin breakdown is ordered for nearly every resident. She doesn't want me to change anyone's bed but just get rid of the Physician's order for the bed.

Should I call the doc over everything I d/c?

Any advice or concerns are extremely appreciated!!

Eric

[Rose_Queen, BSN, MSN, RN]

Writing telephone orders to d/c treatments without actually getting the order is falsification of the medical record and practicing outside your scope of practice. I wouldn't do it, and if this is the norm where you work, I'd run and never look back.

[No Stars In My Eyes]

^^^^DITTO!

Let the DON do all that 'fixing' and have it on HER license! No kidding, she won't back you up if you are caught.

[Rose_Queen, BSN, MSN, RN]

Another thought: which would you rather lose, your job or your license?

[annie.rn]

I agree w/ the above posters. If you lose your job over it, I'm sure explaining in an interview why you left that job will only make you look like a better candidate. One with good morals and a high standard of ethics. Don't follow your boss' orders. Run to the light!

[xoemmylouox, ASN, RN]

I would let your DON you aren't comfortable with this. I would start looking for a new job asap. If they insist they YES you must talk with the MD before you write telephone orders.

[akulahawkRN, ADN, RN, EMT-P]

Writing telephone orders to d/c treatments without actually getting the order is falsification of the medical record and practicing outside your scope of practice. I wouldn't do it, and if this is the norm where you work, I'd run and never look back.

I can't say "this" enough!

[kbrn2002, ADN, RN]

It'll be easy enough to check with your rounding MD/CNP and ask if it is ok for you to d/c those orders, just ask next time the rounding provider is in the building. Our rounding is in house at least three times a week, so you shouldn't have to wait too long.

[ets53]

It'll be easy enough to check with your rounding MD/CNP and ask if it is ok for you to d/c those orders, just ask next time the rounding provider is in the building. Our rounding is in house at least three times a week, so you shouldn't have to wait too long.

This is what I ended up doing. Thank you all for input!

[No Stars In My Eyes]

This is what I ended up doing. Thank you all for input!

Thanks for letting us know what you ended up doing!

[jadelpn, LPN, EMT-B]

If the DON asks you to write telephone orders, I would not assume that you were just to write them without actually speaking to the practitioner regarding the d/c's. So the DON needs to be clearer in instruction/delegating. I am glad that you actually spoke to the practitioners, as this covers your practice.

As I believe, at least in my experience, the practitioner actually has to sign off on the orders within a time frame if they don't write the orders.

Going forward, you may want to suggest a policy change so that all of the things that are negotiable in orders (like special mattresses, padding and the like) are on a nursing intervention/care plan basis and for the practitioner to pick and choose which ones they want and not standing orders.