Disagree with co-worker r/t correctly writing verbal orders

[wilbuild]

I work as a hospice nurse, our admission orders for SNV is 2x/wk and prn, if the patient is stable we write a order to decreasde SNV to 1x/wk and prn and our medical director signs this order. A co-worker says we do not have to write "v/o Dr. Whoever/Susie Q, RN. I say we do? What say you?

[Tweety, BSN, RN]

Verbal orders are going by the wayside to prevent errors. If an MD gives you a verbal order, you are to say "here's the chart, please write the order yourself".

Telephone orders, written was "TORB" - telephone order read back, are allowed. "vo" is not.

[pumlittlekin]

I had one doctor yell at me for not taking a verbal order, he said he was going to tell administration and have me fired. I explained that we are no longer/at least reducing verbal orders due to errors and i gave him the chart with an empty order sheet and he took both but wrote nothing. that doc is an SOB

[NRSKarenRN, BSN, RN]

Home care and hospice are different as there are no docs directly seeing patients like in the hospital and capable of writing orders on chart thereafter

Perfectly acceptable to have "Verbal order read back" or "Telephone order read back" as part of agency standards. Many hospices have gone the route of having a select list of "standing orders" too as part of protocal as means decreasing verbal orders for most commonly treated issues: constipation, n+v, terminal gurgling, SOB, pain.

In my area, a visit range is acceptable to our state reviewers eg " SN 1-2x/wk x 9 + 2 prn/mo for symptom management, catheter malfunction". This gives you flexability to visit based on patients actual needs and escalate if crisis hits without writing tons of orders.

Since ALL orders must come from physician consultation (er telling them what's needed), need to include above verbage. LOOK AT YOUR P+P MANUAL ---orders need to be written per agency policy for that's what gets you in hot water with state survey and JC/CHAPS accreditation.

[Whispera, MSN, RN]

It's unclear if the doctor told you to write the order or if it's just how things are done where you work. If he told you, I'd write "verbal order read back" or "telephone order read back," whichever is appropriate. If it's how things are done, it's probably appropriate to write "per standing order" or "per agency policy," but you have to have the standing order procedure up and running and/or would have to have an agency policy to do it.

You can't write that something is a verbal or telephone order if it wasn't that, nor can you write the other two if you don't have the backup of something written in place...