Doctor Disputing Telephone Med Order - Meeting with DON, Nurse Manager, HR

Nurse Beth, MSN · Jul 17, 2015

Dear Nurse Beth,

I have been called into the office to meet with my DON and Nurse Manager with HR. A Dr. stated I wrote the wrong dose for a med through a telephone order 4 weeks ago. I haven't been to the meeting yet. I am sure that what the Dr. ordered is what I wrote but I am concerned about getting fired. I have a clean record and this is my very first discipline. I have been a nurse for 13 years.

Dear Worried,

I'm so sorry you're in this situation. If you have a good relationship with your manager, I would try to meet with her/him ahead of time to see if she/he is going to stick up for you or at least try to ascertain where they stand and why.

If there was there was no adverse effect, and the dose and frequency, etc., was within normal parameters for the drug, it seems like an over reaction on someone's part, which is puzzling. You are an experienced nurse and know what constitutes a complete and safe medication order.

What is your hospital's policy on telephone orders? Did you document a Read Back and Verifiedâ€ ? Not that it changes the fact that it's your word against the doctor's, but at least you can't also be faulted for not following procedure. Did the MD sign the telephone order?

Telephone orders are inherently problem prone, and yours is a perfect example of why. The only real safeguard against he said/she said is having another nurse on the phone with you to verify what was said.

Unfortunately, if you are an at-willâ€ employee, you can be disciplined for no reason. Fair or not, the facility can choose to back the doctor and discipline you based on nothing more than the doctor's word.

If you belong to a union, take your union rep to the meeting. This may be an investigatory meeting. Check your contract, which should stipulate that you can only be disciplined for just cause. Dress nicely for confidence.

Hugs and best wishes,

Nurse Beth