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Can doctors go against hospital policy?



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Dec 11, 2008 06:20 PM

Can doctors go against hospital policy?


We have a debate going on in my critical care unit and I would love some opinions. Our manager states that the doctors are able to write orders which go against hospital policy and we are to follow these orders. She told us that the doctor would be liable if something happened because it was their order; I disagree. Policies are in place for a reason and if we don't follow them what is the point of having them? My manager's rationale is that this specific policy was up for review and was going to be changed next month. What do you all think? Do the physician orders trump a hospital approved policy?

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25 Comments
No. 1
from feebebe23
Old Dec 11, 2008, 06:28 PM

Default Re: Can doctors go against hospital policy?
my hospital has a policy that states if a doc wants to go against hospital policy he/she has to notify the pt that the order is againts hospital policy and have a consent signed by the pt stating as such.......

whenever this has been brought up.....i have never had a doc go and tell the pt he/she wants to violate hospital policy

works like a charm
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No. 2
from *ac*
Old Dec 11, 2008, 06:30 PM

Default Re: Can doctors go against hospital policy?
I have explained to the doc that I will be writing a nursing note that says, "Per Dr. so and so..." and the doc has changed his mind in a heartbeat.
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No. 3
from racing-mom4
Old Dec 11, 2008, 07:23 PM

Default Re: Can doctors go against hospital policy?
Originally Posted by *ac* View Post
I have explained to the doc that I will be writing a nursing note that says, "Per Dr. so and so..." and the doc has changed his mind in a heartbeat.
Dont all orders say "per Dr so an so"?
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No. 4
from momdebo
Old Dec 11, 2008, 07:30 PM

Default Re: Can doctors go against hospital policy?
As far as I know if you follow an order that opposes established policy then you are as liable as the ordering doctor, the hospital will not back you up. If a lawsuit arises they can name you both, together or in individual actions. As far as the policy being up for review, follow what is on the books at the time. Policies are dated just for this reason. They will check the date of the order against the dates of policies. To remain protected by the facility ALWAYS follow your current policy. Then if there is any action, it's all on the facility. Hope this helps.
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No. 5
from *ac*
Old Dec 11, 2008, 07:46 PM

Default Re: Can doctors go against hospital policy?
Originally Posted by racing-mom4 View Post
Dont all orders say "per Dr so an so"?
I often write, "as ordered". In this case, I'm warning the doctor that I will be writing his specific name down in a special nursing note which will explain why the protocol was not followed. I've never actually had to do it.
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No. 6
from bellehill
Old Dec 11, 2008, 08:12 PM

Default Re: Can doctors go against hospital policy?
Thanks everyone. that is exactly how I felt about the situation. I don't see the hospital backing me up if I did not follow their policy. I am going to contact the legal department and get some clarification. Again, thanks!
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No. 7
from TurnLeftSide
Old Dec 12, 2008, 03:02 AM

Default Re: Can doctors go against hospital policy?
We had this same issue of docs going against hospital policy. We had a patient with a wound vac and the docs wanted the nurses to hook it up to wall suction instead of the suction machine used for wound vacs, a big no-no at my hospital.
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No. 8
from lpnflorida
Old Dec 12, 2008, 04:18 AM

Default Re: Can doctors go against hospital policy?
You pose an interesting question. We have multiple order sets which doctors can use, we also have an order set say for diabetics. It is long it is lengthy. Our physcians can choose to not enact the diabetic order set and therefore write out their own orders for their diabetic patient. While we have pressure ulcer policy and what would be best treatment yada yada . A doctor can still tweak that to what he wants or what he feels is best for his patient.

Perhaps I do not fully understand in what regards to policy? Yes, there are policies and then there are orders. Can you give an example so that I might understand?
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No. 9
from momdebo
Old Dec 12, 2008, 07:49 AM

Default Re: Can doctors go against hospital policy?
The wound vac is an excellent example. The hospital has stated that no wound vac is to be attached to wall suction. The doctor is trying to order the nurse to put the wound vac to wall suction. He can order whatever he wants but the nurse must tell him she cannot do it. She should then advise her charge nurse and I would also tell him to discuss the issue with the charge nurse. If the nurse should follow the order which is clearly in violation of established policy then if that patient has a bad outcome as a result (wound injury, etc) then that nurse is the first one responsible, the hospital would have no fault in the matter because the nurse did something that the hospital clearly says not to do. Hope that helps.
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