Can you give an opioid without a Dr's order?

[chare]

Nurse Beth said:

I wonder, too. I would love to know the context here.

I agree that there is likely more than we were told.   When I read this ...

Nurse Beth said:

[...]

Can you give an opioid without a Dr signing off on it? I say no but my co-worker says yes. I just don't understand if the Dr hasn't signed it than how can I legally give that?

[...]

... my thought was that the MD stated that he or she was going to order the medication, but hadn't signed the order yet.

[Nurse Beth, MSN]

chare said:

I agree that there is likely more than we were told.   When I read this ...

... my thought was that the MD stated that he or she was going to order the medication, but hadn't signed the order yet.

That must be it. Although then I got to thinking  once electronic orders are entered, you're good to go. You may have to wait for Pharmacy to verify...? Still puzzled.

[Tenebrae, BSN, RN]

Nurse Beth said:

You cannot give a meal, or decide an activity level, or draw a lab without a provider's order.

I disagree. 

If a patient is symptomatic with a UTI, we take a urine sample, dip stick it and send it for testing. 

If a patient is unwell, and we check obs and I'll often check a BGL to make sure someone isn't having a low blood sugar.

If a patient is medically unwell and the vitals/pt hx supports a cardiac diagnosis I'll get an ECG done because I know the house officer will ask for it. 

As long as we can provide a clinical rationale for our actions I've never had a doctor chuck a wobbly

on the OP, is this person taking the mickey?

[Nurse Beth, MSN]

@KJL33 Exactly. I've always said you have to know the rules before you break them. I used to take it upon myself to order an ABG or EKG in order to call the doc with results, and move things along quickly.

But I knew I had no authority to do so and trusted the doc to cover my orders. 

edit- in CA we are permitted to perform a fingerstick without an order. That's it.

[FolksBtrippin, BSN, RN]

chare said:

I agree that there is likely more than we were told.   When I read this ...

... my thought was that the MD stated that he or she was going to order the medication, but hadn't signed the order yet.

Yeah, my understanding was verbal order. 

[CommunityRNBSN, BSN, RN]

I wonder if this person isn't fluent in English or is working in a different country where "a doctor's order" means something different?  For example, in the US, all of this would be electronic.  Could they be working in a clinic somewhere where a doctor would hand-write a note, but forget to sign it?.... Who knows.

[Nurse Beth, MSN]

CommunityRNBSN said:

I wonder if this person isn't fluent in English or is working in a different country where "a doctor's order" means something different?  For example, in the US, all of this would be electronic.  Could they be working in a clinic somewhere where a doctor would hand-write a note, but forget to sign it?.... Who knows.

I think you could be right. At a high level it still sounds like a risky shortcut.

[CrunchRN, ADN, RN]

Not enough context given

[vintagegal, BSN, DNP, RN, NP]

For goodness sakes who would stick their neck out there like that? Get the order. Period. 

[MConover13 LVN]

No. 

[Hoosier_RN, MSN]

Tenebrae said:

You realise nurses exist outside of the US right? 

We are allowed to use our initiative based on the clinical picture infront of us so we can provide an accurate clinical picture to the doctors. 

Eg this is the handover I would give to the Dr eg patient is complaining of flank pain, burning on micturition, passing cloudy smelly blood tinged urine. Dipstick showed positive 2+ protein, 2+Leuc, postive for blood, positive for glucose. Patient is febrile. Did a BGL test due to glucose in the dipstick and it came back 18mmol (patient has no history of diabetes). Using an ISBAR I would also suggest that the patient needs antibiotics due to being symptomatic as well as follow up for the high BGL.

Never had an issue with a doctor getting snotty, I think they like it if we can make their job easier

But I doubt any nurse, in any country, would give an opioid without an order. Considering the current dependence epidemic, I think that's a given

[Tenebrae, BSN, RN]

Hoosier_RN said:

But I doubt any nurse, in any country, would give an opioid without an order. Considering the current dependence epidemic, I think that's a given

At the risk of being sarcastic well duh

The poster quoted me. I figured they were talking to me

As for the opioid epidemic, thanks US pharma and the Sacklers.