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.

[dimpledRN]

I would use this as a learning experience. You were absolutely right to stand your ground. But unless you get the order from the doctor yourself don't pull a narc. And definitely don't give it to someone else to give because if you don't know them how do you know they aren't keeping it for themselves and now your name is attached to it? I haven't been put in that position and would never put a coworker in that position. That nurse was 1000 million percent in the wrong putting you into that position. I would talk to your manager if I were you just to cover yourself. I don't know how it is where you work but most managers would appreciate the heads up. Wishing you all the best!!

[luv2]

Never let anyone MD, NP, P.A verbally tell you to give a medication without an actually having a medication order because that is how nurses get in trouble. It not as though this nurse told you to clean this patient because they were short staff. The nurse verbally told you to place an order for a medication that you did not verbally speak to the provider.

2 things

1- whenever there is a verbal order legally 2 nurses are supposed to have readback.

2-never let anyone tell you to take a medication without you checking the order first. If you do not see the order than get one from a provider. No verbal order especially with narcotic have the provider place the order themselves and have pharmacy verify the order before you taking anything.

[kbrn2002, ADN, RN]

Never let anyone MD, NP, P.A verbally tell you to give a medication without an actually having a medication order because that is how nurses get in trouble. It not as though this nurse told you to clean this patient because they were short staff. The nurse verbally told you to place an order for a medication that you did not verbally speak to the provider.

2 things

1- whenever there is a verbal order legally 2 nurses are supposed to have readback.

2-never let anyone tell you to take a medication without you checking the order first. If you do not see the order than get one from a provider. No verbal order especially with narcotic have the provider place the order themselves and have pharmacy verify the order before you taking anything.

Your first point confuses me some. If an MD/NP/PA verbally tells you to give the medication that is an order so yes, the med should be given but only after entering the order in the MAR. If you are talking about OP's scenario where another nurse said "this is the order, give the med" then no, I absolutely wouldn't administer the med before the order is in the MAR.

Maybe the rules and regulations are different where you live, where I live we do not require 2 nurses for confirmation of a verbal order.

With the exception of controlled substances. Pharmacy requires a written Rx for schedule 2 meds, while they prefer a written Rx for all controlled meds they will accept a verbal order direct from the MD for a small amount of Schedule 3's. We run into this occasionally if an Rx runs out over the weekend and we need to have an on-call refill the med in an amount to get through the weekend until we can have the primary refill the med on Monday

[psu_213, BSN, RN]

Your first point confuses me some. If an MD/NP/PA verbally tells you to give the medication that is an order so yes, the med should be given but only after entering the order in the MAR. If you are talking about OP's scenario where another nurse said "this is the order, give the med" then no, I absolutely wouldn't administer the med before the order is in the MAR.

Maybe the rules and regulations are different where you live, where I live we do not require 2 nurses for confirmation of a verbal order.

I have never heard of the 2 nurse rule...

I have worked in a community hospital where there is a 0% chance that a physician is going to go to his/her computer at home during the middle of the night and put in an order. I'm not going to let a patient sit there all night without pain meds because the doc is being a poo poo head. (And administration would never stand up to doctors who did not put their orders in.). I'm still going to put a VO in before I give the med, and I'm definitely going to make sure someone else puts in order in if they took the VO.

[Horseshoe, BSN, RN]

I have never heard of the 2 nurse rule...

I have worked in a community hospital where there is a 0% chance that a physician is going to go to his/her computer at home during the middle of the night and put in an order. I'm not going to let a patient sit there all night without pain meds because the doc is being a poo poo head. (And administration would never stand up to doctors who did not put their orders in.). I'm still going to put a VO in before I give the med, and I'm definitely going to make sure someone else puts in order in if they took the VO.

I have heard of a 2 nurse requirement for a telephone order, but not a verbal. It sounds like some people here are conflating the two, and they are not the same.

Also, I've given many meds immediately after a verbal order before it makes it to the MAR, usually as part of a procedure or semi or full blown emergent situation. In these cases, I ALWAYS repeated the order back to the doc, and then once I'd drawn it up, I'd say, "I'm now giving ____ x mgs. IV push." You can't be too careful, but there are some situations where it would not be prudent to say "I'm not giving that med until it's entered into the computer and put on the MAR."

[psu_213, BSN, RN]

I have heard of a 2 nurse requirement for a telephone order, but not a verbal. It sounds like some people here are conflating the two, and they are not the same.

I have never heard it for a telephone order either. Must be a regional/hospital thing. I have been the 2nd person on a line to witness an over the phone consent. but I have never had to have a witness for a phone order.

[Horseshoe, BSN, RN]

I have never heard it for a telephone order either. Must be a regional/hospital thing. I have been the 2nd person on a line to witness an over the phone consent. but I have never had to have a witness for a phone order.

I just have a vague memory of hearing of this practice. I personally haven't had to do that.

[twinmommy+2, ADN, BSN, MSN]

The only two things I can see you did wring were getting a narcotic out with an override and giving it to the nurse without returning it to the omnicell. If the patient complains they didn't get their med dose it could be bad for you as if you diverted the med. Talk to your preceptor about it .