doctors order

DG5 · Jul 28, 2004

AND if there still is some doubt to what you have heard even after reading it back and getting the reply, ASK AGAIN until you are 100% sure you have it straight. Even if it means another phone call. Don't let any Dr. intimidate you or make you feel you are stupid. Your standards, licence and professionalism is what counts.

Trauma Columnist · Jul 28, 2004

Our hospital now requires read back, math back to ensure correct med and dose. Its your license on the line - speak up! If they hang up, call them right back and address it: "I'm concerned for pt safety, so I need to read these orders back to you."

zacsmimi · Jul 29, 2004

When I was a new grad from Maine, I started work in Texas, where many docs are Hispanic and

1)have heavy accents and

2) OFTEN spoke in partial Spanish phrases.

They were SO annoyed with me, all the time, I could rarely understand them the first time, and almost never over the phone. I learned to say, right up front, this is so and so from so and so, Im caring for your patient so and so. State the problem, request the order, and then IMMEDIATELY say "IM A NEW GRAD, or IM NEW or whatever, and I need you to repeat, or spell or whatever - and then read back. Yeah, your license is on the line, but more importantly, so is your patient.

Dont ever be afraid of the docs. They dont have any more right to courtesy than you do. I have found that they act pretty much the way I expect them to act. So I set the stage early on and we dont often have problems. We are partners. I dont apologise for calling them back. I didnt make a mistake. "Dr Jones, Im sorry, I did not have the opportunity to confirm this order." is sufficent.

Good luck!

adidas99 · Aug 2, 2004

Hi, I did want to read back to them but the problem was they already hang up the phone.Its a good thing that pharmacy checks the order and corrects them....

That's when you page them again, and tell them you needed to clarify what was said. Our floor doesn't have that problem really w/ a doctor hanging up after giving an order. But if they did, we dont hesitate at all to page them again.

DANRN2000 · Aug 2, 2004

Hi, I did want to read back to them but the problem was they already hang up the phone.Its a good thing that pharmacy checks the order and corrects them....

Call them back and insist on reading back and verifing the order. After a few call backs at 0200 they'll stay on the line and let you finish. Believe me it works!

Stitchie · Aug 2, 2004

Yep, always read back. I tell the doc right up front that I'll be reading back the orders when we're done. I don't often take TO's since I work ED but once in a while the doc refuses to talk to the resident and wants the nurse...who knows why. Except that my line is:"I'm going to read these back to you when we're done to make sure I've got down for the floor what you are asking for". Inevitably, the docs are nice about it, and allow me the time to do what I need to do.

I never apologize to a doc for calling them, and I never say "Excuse me sir". I expect collaboration and if they yell, I go straight to the medical director of the ED. Sometimes a doc will make a scene because of miscommunication and because our ED is so disorganized, but for the most part the PMD's work well with the ED staff.

Demand respect, tell them you're a new grad or new to the unit, and they will accomadate you. Failing that, ask your preceptor.

DANRN2000 · Aug 2, 2004

Yep, always read back. I tell the doc right up front that I'll be reading back the orders when we're done. I don't often take TO's since I work ED but once in a while the doc refuses to talk to the resident and wants the nurse...who knows why. Except that my line is:"I'm going to read these back to you when we're done to make sure I've got down for the floor what you are asking for". Inevitably, the docs are nice about it, and allow me the time to do what I need to do.
I never apologize to a doc for calling them, and I never say "Excuse me sir". I expect collaboration and if they yell, I go straight to the medical director of the ED. Sometimes a doc will make a scene because of miscommunication and because our ED is so disorganized, but for the most part the PMD's work well with the ED staff.
Demand respect, tell them you're a new grad or new to the unit, and they will accomadate you. Failing that, ask your preceptor.

LOL- Brings back memories. As nursing student my instuctor overheard me apologizing to MD for calling them for orders. She demanded I write 3 page report explaining why I was apologizing. Needless to say I couldn't come up with 1 paragraph. Point taken!

janleb · Aug 3, 2004

When I was a new nurse, and even now I repeat the order back to the physician. I write up a list of topics I want to cover with the doctor, being a pt condition abnormal labs, concerns ect. Because some doctors talk and give orders so fast you can't get a word in edge wise. I wouldn't worry to much about aggravating some doctors time, a wrong order that could hurt a pt is a worse scenerio. Ask them to repeat the order. Better to repeat than to have to have them paged again for the same concerns. When I was orienting as a new nurse A lab or procedure was not done, And a physician almost had me in tears, he was just having a bad day. He felt so bad that after that he was hi Janice , how are you ect ever since then. So just remember the most important is the pt.

Stitchie · Aug 3, 2004

LOL- Brings back memories. As nursing student my instuctor overheard me apologizing to MD for calling them for orders. She demanded I write 3 page report explaining why I was apologizing. Needless to say I couldn't come up with 1 paragraph. Point taken!

So what did you say? Good for your instructor, though -- why apologize when we are doing our jobs?

Anywho, back to the OP's question: if you can't understand, or if it's loud, say so. If the cell phone connection is lousy and keeps breaking up, say so. It won't be the first time the doc has heard these complaints. If the doc is eating (my personal fav!) I always use this line: "I'm having a very difficult time understanding what you're talking about. Should we talk at a different time?"

And I should enter a caveat about never apologizing: I did have to apologize to a doc on Thanksgiving when I had received a NH admit to the unit and didn't see an extra page of regularly scheduled meds. He took it v. graciously and even apologized to me that I had to work so much on a holiday. Since I had to page him twice when I could hear dinner going on I did honestly feel bad about that.

So that's my story. Not all docs are ogres; in fact, most aren't, especially if they know you're new and want to learn.