Discussion about T.O.s

[narn]

Hi ladies and gents, first post to the site and new member. I have been a nurse almost 3 years so I'm just seeking all advice and knowledge I can. a few days ago I came to a situation that was new. I had a pt. that c/o cough, who was running low-grade temp. I called MD early AM since I work 3rd shift, and md gave me an order for chest X-ray and an order for PO ATB. While giving me the order he ordered something along with the PO ATB that I didn't quite understand (the primary MD has a foreign accent that's hard to comprehend at times) i asked him to repeat and he became aggravated (I was calling at 6am so I assumed he was already aggravated to be receiving calls) so he repeated and hung up. Since I didn't wanna call and further piss him off... I wrote the order for chest X-ray and PO ATB (bactrim) and since dealing with this particular md often, I know he prefers to order bactrim with macrobid as well, so I wrote the order for macrobid without being entirely sure. Common whereas I don't see this such a big deal is standard protocol is once the results of chest X-ray is obtained, If normal, just continue PO ATB to fight the infection, if abnormal, md is called and he commonly orders either IM rocephin along with ATB. Just wondering everyone's thoughts and feelings any of you have ever had a similar experience. Would love any comments or insights you may have.

Cheers! 😁

[heron, ASN, RN]

When taking a telephone order, I've made it a practice to read it back to the doc, who can then confirm that I've got it right, or correct me if I have it wrong. In this case, I'd suggest that either you or the nurse relieving you should call the provider and get clarification.

It's very hard to deal with cranky providers, but I'm even more uncomfortable guessing at orders I don't understand. It kinda verges on practicing medicine, I think.

[macawake, MSN]

md gave me an order for chest X-ray and an order for PO ATB. While giving me the order he ordered something along with the PO ATB that I didn't quite understand (the primary MD has a foreign accent that's hard to comprehend at times) i asked him to repeat and he became aggravated (I was calling at 6am so I assumed he was already aggravated to be receiving calls) so he repeated and hung up. Since I didn't wanna call and further piss him off... I wrote the order for chest X-ray and PO ATB (bactrim) and since dealing with this particular md often, I know he prefers to order bactrim with macrobid as well, so I wrote the order for macrobid without being entirely sure.

I've experienced the same thing on a couple of occasions. When I couldn't understand what the physician was saying even after asking for clarification, I gave him/her my cell phone number and told the them that I needed them to send me a text with the name and dosage of the medication they just ordered. Otherwise I wouldn't be able to administer it/them since I wasn't sure exactly what they'd just ordered. They complied. One did get rather upset at me, but I calmly explained that I needed to get the order right.

[SleeepyRN]

When taking a telephone order, I've made it a practice to read it back to the doc, who can then confirm that I've got it right, or correct me if I have it wrong. In this case, I'd suggest that either you or the nurse relieving you should call the provider and get clarification.

It's very hard to deal with cranky providers, but I'm even more uncomfortable guessing at orders I don't understand. It kinda verges on practicing medicine, I think.

Yep.

I recall from nursing school repeating the order back as basic protocol, not just a suggestion. And this not only verges on practicing medicine, it IS practicing medicine...prescribing without a license.