Can a doctor ask a nurse to write the order when she is standing right there??

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Hello All,

I am a relatively new nurse and work for a psych. facility. Many times, the doctors just ask us nurses to write the orders for them when they are right there..These are the orders when they are not very clear about what to do or they want us to do something that is against the policies. i.e. -- we had a patient who required many very expensive medications. Our policy says that we will only administer the medications that were ordered for the patient from our pharmacy and will not use any medication that the consumers bring with them from home. But there are exceptions when the doctors would give us an order to use consumer's medication. So, the other day when the case worker brought in medication for one consumer -- doctor just told me to receive the medication, identify them and confirm what they were and write an order on her behalf to use those medication for the consumer. My manager inter wined and said -- sorry doc, but nurses can not dispense the medication. So, the doctor gave us a nasty look and opened the bottles to see if the medications were what they said on the bottle. She also said -- well, how am I suppose to know what medications are these??? Lucky for her -- all the bottles were sealed, so she just gave all of them to us and said -- ok, you can write down all the medications and write the order for me now..CAN SHE DO THAT??? Can someone please tell me where can I look up the information about when are the nurses responsible to write the orders for doctors?? I will appreciate some guidance as if how to handle situations like this. ..thank you all.

Specializes in ER; Primary Care.

I do write orders out for doctors and providers all the time... I just make sure to have them read it over and sign it. It's not that different than taking a telephone order, right? With a telephone order, you still write out the order etc., and they come in later to sign it.

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Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

JCAHO is discouraging verbal orders. Phone orders are suppose to be signed within 48 hours. Verbal orders use to be very common, when rounding you would take the chart and write the orders for the MD. I hand the chart to the MD giving me a verbal now and tell them they have to write the order. Times change. We use to get the docs coffee and give up our seats to them also :)

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I am an LPN in Long Term Care in Indiana, and we write at least 50 verbal orders a day, and it is perfectly legal, part of our scope of practice, and if you are a nurse that wouldn't write a verbal order, you would never find a job here. I'm sure the rules are different from state to state, but have just never heard of nurses not taking verbal orders over the phone or writing orders that are being given to you verbally by the physician that is making rounds with you and standing right next to you. It's done every day of the week here.

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as a total sidenote: are they teaching in school that patient's are now called "consumers???" That is ridiculous. First patients, then clients, now CONSUMERS?

I would think the med questions and orders are specific to your facility.

Laugh out loud

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Specializes in ICU, ER, EP,.

I'd be happy to lend the doctor my pen......;)

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Specializes in ER.

consumer makes the patient sound like they're buying a ticket for an airline... or whatever. Less personal and it's just a reminder to us and them that they're purchasing a service. Makes me feel uncomfortable, and as a patient I'd feel uncomfortable too. Where do these changes keep coming from???

Patient is best. I'm not going to call any of them client or consumer, or whatever else they can muster up to sound P.C.

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Specializes in ER.
JCAHO is discouraging verbal orders. Phone orders are suppose to be signed within 48 hours. Verbal orders use to be very common, when rounding you would take the chart and write the orders for the MD. I hand the chart to the MD giving me a verbal now and tell them they have to write the order. Times change. We use to get the docs coffee and give up our seats to them also :)

oh, what about the docs getting the best parking spots at a facility???!!!!! Even above handicapped parking spots!!

GEEEEZZZZZZZ!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Seems like they're trying to go back to giving up our seats, getting them coffee, heck why not a back massage while we're at it??

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Specializes in ICU, ER, EP,.

Nah, our policy is verbal orders only in a rapid response call on the floor or a code in the units. I simply state... "Joint commission won't allow it... as long as you write it, I'll make sure it gets done... here is the chart".

Our cardio surgeons were notorious for this and the old culture encouraged it. A new policy, a chat from the medical exec... their boss... fixed it with the addition of holding offending nurses accountable... and that changed the old culture fast. "here is the chart doctor".

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Yes, I have written orders up for doctors while they were rounding on my patients. Trick is to have them sign your written work and not have them skip out on you!

That doesn't bother me because then they have to go to medical records and sign all the verbal orders as well as the telephone orders :lol2:

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Many times I'll tap a doc for orders while he's waiting on the phone and working with another chart. If he says OK, I'll write the order for him, then while he's talking, I'll silently hold the chart out to him with a pen so he can sign it. Mimimal interruption. They like this.

I'm always ready to get any order my pt needs. If I pass a doc in the hall, I'll get a VO. They also like this because I'm helping them make the most of their time.

I'm all for anything I can do to make the doc's life easier. Our docs' time demands are even crazier than ours.

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Specializes in critical care, PACU.

most of the time our mds are great about writing the order themselves if I ask, but if it's late at night and they just want to get out of there we usually just TO it. They are surgeons though and have to be awake to operate the next day so we are usually okay with that as long as it's not totally unreasonable.

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Specializes in critical care, PACU.
Times change. We use to get the docs coffee and give up our seats to them also :)

hahaha! we still do this :D

  • coffee and chair voluntarily given to the nice docs
  • begrudgingly leave the chair (and no coffee) for the grouchy ones

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