Accepting verbal orders from another nurse?

[amberrenae, RN]

I'm a new RN a little over a month into my orientation on a busy med/surg unit. Tonight at a few minutes before the end of my shift I had finished reporting off and was sitting at the nurses station when a float pool nurse I had never worked with before asked me to push morphine for her patient. She had just started giving report and was trying to avoid overtime. I brought the morphine into the room but wasn't able to scan it because the patient didn't have an order for it in the eMAR. I returned to the nurse and told her the morphine wasn't ordered, and she said she had taken a verbal order and I should enter the order. I said I didn't feel comfortable entering orders I hadn't taken for a patient I didn't know, and she said I could just push the morphine without scanning it and she would enter the orders and document administration when she finished report. I hesitated again, and she snatched the morphine from my hand and stormed off to give it herself.

Am I in the wrong here? I don't want to be seen as not being a team player and I'm sure things like this happen, but I also don't want to risk the license I just earned.

[SaltineQueen]

You were absolutely correct to not give it. But I wouldn't have pulled it, either. I would talk to your preceptor and unit manager ASAP about the situation because I can almost guarantee

'they" will come looking for you wondering about the morphine you pulled but didn't give.

[caliotter3]

Certainly hope to hear that when you talk to your manager today that you are not in a great deal of trouble over pulling the med. Good luck with the interaction.

[sevensonnets]

Oh no!! Klone's right, that smacks of diversion because it was diversion. She could've gone to any experienced nurse with that request but she picked you because you didn't know any better and she knew you'd fall for it. All she had to do was feign 'outrage' and you handed over the morphine. She won! Now you have to convince your manager of that.

[Here.I.Stand, BSN, RN]

Uh... you used correct practice to prevent safety violations!! THAT is being a team player!! I mean nursing school 101 -- you cant check ANY med administration "rights" with nothing to check the drug against. Plus, mere telephone and verbal orders aren't supposed to be done; the nurse is supposed to READ THE ORDER BACK. You can't do that here.

I'm not typically one to worry about losing our license. BUT, if you practice medicine AND pharmacy you WOULD lose your license. No order: practicing medicine. No verification or dispense: practicing pharmacy.

So anyway, heck no. The physician really should enter the order him/herself. A distant 2nd option is for the RN to enter it -- only if the MD is busy with a true emergency.

Sorry for all the caps... this nurse irritated me.

[JKL33]

Another thought: Personally in most instances I wouldn't even enter a verbal order that another nurse took and I didn't hear. Why? Because I don't think it's an overall good thing. About the time that becomes acceptable practice on a unit then I have lost the ability to control or even have knowledge of what all people might use my name to enter for patients I know nothing about.

In other words it's going to get bad for each one of us, eventually, if someone else can say they are acting upon (entering "for us") a verbal order that we supposedly took. They can do that if we have no knowledge of a situation.

Agree w/ klone and others regarding the fact that your pulled med is unaccounted for.

Best wishes getting this sorted out ASAP....give us an update!

[Meriwhen, ASN, BSN, MSN, RN]

The only verbal order I'll take is one that I took directly from the provider. If another nurse wants to pawn a verbal order off on me...well, let the other nurse first enter it into the EMR and sign under THEIR name as the one who took the verbal order from the provider, and then we'll talk about whether I'll give the med.

The only exception to this might be if I was a witness to the verbal order. Even then, that's debatable.

[Have Nurse, ADN, RN]

Nope. This has nothing to do with being a "team player, " Darlin. You did just fine. And, you KEEP protecting that license.

[Footballnut]

I expect everyone to put in their own orders unless it's an emergency situation. I even wrote up a physician who became upset because he wanted me to put in his orders even though he was standing right by a computer. We have a strong policy in our hospital. The less an order is passed around verbally, the less chance of an error.

You may have gotten played but kudos to you for standing up in this situation.

[Crush]

I only enter an order for a narcotic in an emergency and at that only if I directly got said order from the physician w/ a good read-back. 99.5% of the time the doctor is the one who puts in the orders. As mentioned, the less verbal orders there are, the less chance of a mistake happening.

[amberrenae, RN]

Update! I talked with my manager, who went into the patients record and saw that the nurse had put the order in and administered the dose a few minutes after the incident. She thanked me for letting her know and for not giving the med without an order, and said that this nurse is very experienced and knowledgeable but this wasn't the first time something like this had occurred with her.

Thanks all for the advice and support, this has definitely been a nerve wracking but valuable learning experience for me.

[psu_213, BSN, RN]

PLEASE talk to your manager about what happened TODAY so that you do not get implicated in this.

Totally agree. You were definitely right in not giving the med; however, the issue now becomes that you pulled a narc that you never gave. Talk to your NM now and explain the situation before someone raises a stink about a missing vial of morphine.

ETA: I posted this before I got to the OP's comment right before this. Glad it worked out! In the future, see the order/MAR first and never let someone give a narc that you pulled out (at least not without witnessing them).

[caliotter3]

That was a close one. Glad you came out on top.