doctors order in hemodialysis

[ICUdialysisRN]

Can someone help me, I'm still confuse. I am icu nurse and responsible also in hemodialysis in-patient and out-patient (even our hospital dont have dialysis unit). For the clear order, icu specialist doctors can make order for the hemodialysis? Or the nephrologist should be the one who will make the order? Because our nephrologist will make dialysis order in the first session of the patient then the next dialysis the nephrologist will verbalise to our ICU doctor " do dialysis with the same previous order".. Is this what should the nephrologist responsibility in making dialysis order?

[kdunurse]

If I understand you question correctly, you're asking who should write the dialysis orders, the intensivist or the nephrologist? It should always be the nephrologist who writes the dialysis orders, although it gets confusing when the intensivist is also a nephrologist. If that's the case, you need to look to hospital policy. In our hospital, we have some (lazy) nephrologists who will write "use chronic dialysis orders" or "use previous dialysis orders from x date", in which case I will write an order clarification listing the entire dialysis prescription from the previous order. Your facility may not allow this, so it's best to follow facility policy. And if there's any confusion, you should always call the nephrologist for clarification.

[ICUdialysisRN]

So, every dialysis treatment of the patient, the nephrologist should assess the patient and make new dialysis prescription? Most of our doctors in our hospital are all lazy to do their part in writing their orders, so nurses is always reminding them to write their orders ( spoonfeeding)..