Coverd by doctor order beetwen nurse judgement and and I don't care I am coverd

[zuzi]

"Coverd by doctor order" is another crepy think that I seen here.

Is a vicious circle between a nurse assesment and judgment and the doctor order. So... you asses the patient, document, inform the doctor, YOU are are accountable of what do you tell to doctor and the doctor is accountable about what he ordered to you. Any other mixed in this link is just a DEVIANCE.

Accountability in nursing profession is all that we NURSES we have.

Clarify is for patinet well beeing. If somenthing is unclear...CLARIFY! Bothering by someone with your questions...is just DEVIANCE.

Let me to give you and exemple a case to study...looool

Patient admitted at 1pm with suspected DVT lover extremities. Postive DVY dopller at 5 pm. Dr orderd anitcoagulants. 1 am midnight... patient is NOT on anticoagulants! 3 RNs was there working with, 3 charge nurses worked with and many others.....looool

Pharmacy transcribed doctor order anticoaglaion therapy to be started with NEXT!!!!!!!!! day in the afternoon. More than 24 hour patinet with DVT confirmed not coverd with anticoagulants!!!!!!

You need to TALK! TO CRY TO SHAKE! Is a patient life there! But I am just a foreign RN with my kuku musical mind, loool who bother others, loool.

Applying american standards... need to write up people and don't care, loooool. I preferd to clarify and to do the good staff, and i was lucky to have logical mind close to me. I will miss so badly them....

I could not stay and work in a terror working place to be. I am scared to speak up ....I am scared also to work....coverd by THESE type of trinscribed orders... and i don't care style to be....

Tell me about you... about... "coverd by doctor order"...

[zuzi]

We already fixed the problem in that night, tk God with a smart charge nurse, enough open mind to hear Zuzi issue. What is wrong is that IS HAPPEND and probbaly will be happend again.

When a doctor add new medical orders is better to know when you will start them...special when is some important for patients.

Assuming that you are coverd by doctor order (in this case and order transcribed by pharmacy) IS NOT AN ISSUE, when patient need that medication. If doctor wished to medicated patient starting to next day... he will add "starting from next day" until then... use your brain!

Are many cases when chronic ill patients with medication took from years at home... skipped meds... just because doctors don't know about ... or nurses didn't talk with patients about and announced doctor. Is a big lack in communication.

Patients who go and comeback from surgery, forgoten to DC meds previously of surgery or revise the meds after surgery.....

If a doctor order is there or is not there,(from thosuand of resons), and you know that could be a questionable one, in the new patient condition, you will fallow it, just because... ..YOU ARE COVERD WITH A DOCTOR ORDER, or YOU ARE COVERD WITH A NONEXISTING dr order.

This is sickness all in all.

I have right I know that I have it... but I will not writing anyobody up, is not my style, Is about much more, I let people who enjoy it, to do it, looool, I didn't came here to clean their mess, they need to clean them self or to stay in it. I am out of there! Life is so beuatifull out of it!

Be good nurses and stay up for your beliveness!

Yes is a broken english but I know that I have right!

[chicookie, BSN, RN]

Yes is a broken english but I know that I have right!

YOU ARE SO CUTE! I know this is off topic but I don't have anything to add. But I do have fierce admiration for good nurses that work through adversity! Even if its getting your point across to a doctor or standing up to people that can't tolerate a little broken english.

A nurse that can perform well in a place where she/ he doesn't understand the language or speak it perfectly is a way better nurse than a nurse that can speak the language well and can't perform at the level you do!

KEEP UP THE GOOD WORK!

[kellykelly]

Thanks leslie.

I hope you were not offended by my response, zuzi. I was truly wondering if you are having problems getting your point across due to a language barrier. That's not a judgement against you but it can be an issue in the workplace. Of course, that does not excuse the other nurses for not catching the error and for not knowing WHY they needed to start the anticoagulants right away, not the next day.

[caringchic]

You are right, dont let anybody feed you junk because you are foreign, who cares, you are a nurse. Clarification is the key, pt outcomes are directly affected by lack of communication, never doubt yourself in seeking accurate communication/ subsequent documentation! Nursing isnt for sissies! :) Keep up your thorough nursing practice.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Zuzi you are correct in that you will run across many nurses, aides, unit clerks etc, who will do as little work as possible to get by. Many will defend themselves with flimsy excuses, like "the MAR said to start the med tomorrow". This may technically get some "off the hook" and allow them to continue working, but it isn't right. I have learned over the years that many of the staff I work with are like trained monkeys,..they do the tasks they are required to do, follow the list of things that need to be done, but don't think on their own.

Critical thinking skills is what sets out a good nurse from the ones who are just there to collect a paycheck. You keep using that brain of yours and give the best care to your patients that you can. Write up your concerns and go on. As sad as it may sound, you can't save the world (trust me, I've tried for years, it's exhausting and can't be done), but you can make a difference to the patients under you care. Fix the mistakes you find, do the best you can and move on. You are a smart nurse who sees the whole picture and truly cares about her patients. Don't let anyone change that about you!