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.

[kbrn2002, ADN, RN]

You absolutely did the right thing. I would never enter a verbal order passed from nurse to nurse, much less a narc order. It's like a game of telephone, you have no way of knowing if that med/dose are even what the MD said if you didn't hear it yourself.

I couldn't even get a controlled med out of our pyxis unit without the order. Pharmacy won't clear a controlled med without a written Rx for schedule 2's. Schedule 3's require a minimum of a verbal override to dispense from the ordering MD given directly to the pharmacy. Pulling the med from the nurses say-so without a MD signing off on the narc just can't be done.

[MissourigalRN]

BRAVO! It sounds to me like you have a good head on your shoulders. You worked hard for your nursing license and you need to work hard to keep it. You don't know if that other nurse even got a verbal order for the morphine, she could have been making her own orders. There are other situations in which putting in someone else's orders may be okay but with this being a narcotic, a nurse you didn't personally know, and a patient you weren't familiar with I wouldn't have done it either. Kudos to you for lending a helping hand to your teammates by the way! That's hard to come by these days.

[LPNDebbie]

You were correct. On the bright side, hopefully she never asks you to do this again! If you did do it just so she could avoid OT, you could have gotten written up, lost your license, etc. You worked too hard for your license just because of some rude nurse.

[EaglesWings21, ASN, RN]

No you were not wrong and wise to do what you did.

I have however taken orders from a very wise charge nurse when a patient was decompensating and the doctor took 10 years to get to the bedside. When the doctor arrived she would just calmly tell him what he did so he could enter the orders in the computer. I would take her over a resident any day!

[Nursedeb1989]

I have been a nurse for 28 years and if i didn't take the order, I won't write it. what if she heard it wrong and you have the wrong dose/drug etc to possibly the wrong pt?

[akulahawkRN, ADN, RN, EMT-P]

I won't accept verbal orders for me to enter into the computer from another nurse, even if it's my Charge. It's not that I don't trust them, it's that it's my license. I will have them do the order entry because they were the ones that took the order and so it's their name attached to the verbal order entry, not mine. Where I work, we very much prefer to have our providers enter their own orders into the computer and they're usually really quick at entering their own orders. It's relatively rare for me or any of my fellow nurses to take a verbal order, but it does happen.

[wondern, ASN]

Tell her to blow it out her blow hole in a most courteous professional way of course! Did you draw it up or did she? Do you even know what was in the syringe?

Why is her time more valuable than yours? Her working hours are her problem. Sounds like a diversion tactic at the change of shift with no order. You can't take a verbal order second hand. Why would you even dare ask someone or put them on the spot without even an order? Oh yes so she wouldn't get OT?!

[RhythmicRN, ADN]

You did the right thing. I absolutely would not take a verbal order from another nurse. I was once asked to give an IM psychotropic med that another nurse drew up in a syringe. I did not give it because I did not draw it up. You should contact your manager about this. Good call!

[auntiedebe]

No the 5 rights, or 7 or 8depending on which source you use, of med admin need to be followed. This is your standard as a nurse. And verbal orders should only be taken in emergent situations. Stick to your guns girl!

[Fiddleback]

Had a big public blow up with a charge nurse on my psych unit one night over a stat order for Benadryl of all things. The doctor had told the charge nurse she would enter it in a few minutes. My charge wanted me to go ahead and give it. I refused because I hadn't seen the order with my own eyes. I stuck to my guns and when the order appeared on the computer it was for Vistaril 500MG! I took a copy of the order to the charge nurse who had yelled and screamed at me five minutes earlier and handed it to her in the middle of the lounge area and said very sweetly "since you talked the to the doctor would you like to call her back or should I?" She very quietly took the order back to the office and called the doctor who dc'd the first order and correctly ordered the 50mg of Benadryl. Original order had wrong drug, definetly wrong dosage. I don't trust anybody until I see it for myself. By the way, that particular charge nurse has never tried to order me to do anything like that again.

[Wisco50]

No, you were not wrong, she was. She likely knew it, too.

Signed, retired c 43 yrs of hospital nursing

[guest317]

Sorry, I am rather hardcore about this. Even if it was a nurse I knew well, I would not take his or her verbal order for this. At the time you give the medication, if there is no documented order, you have no idea exactly what the order is. Suppose the receiving nurse wrote something different than what you gave??? She would likely throw you under the bus. Besides you would be at fault for giving the medication without an order. All the "what if's" come to mind. What if she forgot to write and transcribe the order and went home? When reviewing the narcotics there would be a dose missing yet no order for it. If the cart noted an override and you were the one signed into it, the responsibility would fall to you. Best practice would be to ask the nurse to write the order first, and then if all was in order, you could administer it. In this day and age of stricter control of narcotics I would not take a risk of putting myself in a compromising situation. Besides, this nurse should have known better!