Docter refuses to give written orders

[mactheknife]

Have any of you ever had an anesthetist insist that he does not need to give you a written order to give a patient medication if he is in the department with you? This incident has happened three times in our PACU, post surgery. This one claims that if he is present a verbal order is all that is needed. He is willing to sign next to our signature in the nursing notes where we record giving the medication, dose and route! Where can I find it in writting that all docters orders must be written on a docters order sheet and signed by the prescribing docter? We really need all the help we can get.

[shodobe]

Anesthesia usually gives our PACU nurses a verbal order. They write it down and get them to consign. If they don't then it comes back to haunt them as unfinished charts which could reult in a suspension. I see no real problem unless you think it is a matter of principle where you just don't want to take the time to write it down. I don't think in all my 30 plus years I have ever heard a PACU nurse complain about this. I think they are just glad they can get anesthesia to even give them an order. I guess it would be unique to your facility and anesthesia group.

[lindaloo51]

Our anesthesia staff has standing orders that are checked off and they must sign. Verbal orders are written by the nurse and must be signed by the MD or as you say it will come back to haunt them as an unsigned chart.

[shodobe]

Our anesthesia staff has standing orders that are checked off and they must sign. Verbal orders are written by the nurse and must be signed by the MD or as you say it will come back to haunt them as an unsigned chart.

In the eyes of JACHO there are no such thing as "standing orders" anymore. Yes, we have an anesthesia sheet that has medication orders and such, the anesthesiologist checks off what they want and signs the sheet. We are never allowed to call it standing orders anymore. Verbal orders are what they have always been, nurse writes it down and MD signs them later.

[Rose_Queen, BSN, MSN, RN]

We are not allowed to take verbal orders except in code situations. So if the doc is standing right by the chart or even in the hospital, she/he needs to write it before we can give it. However, every anesthesia provider transports a patient to recovery with a narcotic kit, and until they have finished report and signed off, they can continue to give the narcs. We also have the preprinted order sheets that just need to be checked off, and most of the docs fill those out when seeing the patient preop.