document signing

[carolinalpn, BSN, RN]

Hello all, I am a fairly new nurse i have been working for just 3 months as the only nurse in a PM methadone clinic in South Carolina . I would like to get some opinions on something that keeps occurring. I am responsible for faxing orders to the doctor that our counselors put in for pts. to go up or down on their doses. During the AM program the nurse that works is supposed to review and sign off on the orders before she leaves this however has not been happening. This leaves me to sign off on the orders and send them. My problem with this is that i do not know these patients and do not feel comfortable signing these orders. If something were to happen i would be held responsible for it because i am the one who signed. Am i right about this. what would you all do?

[Mazee]

During the AM program the nurse that works is supposed to review and sign off on the orders before she leaves this however has not been happening. This leaves me to sign off on the orders and send them. My problem with this is that i do not know these patients and do not feel comfortable signing these orders. If something were to happen i would be held responsible for it because i am the one who signed. Am i right about this. what would you all do?

Exactly, if something were to happen you would be held responsible! Your basically signing your license away. I wouldn't sign anything that I had nothing to do with. I was told the same when I did my community nursing in a meth clinic. Seek advice from your supervisor and see what the policy is about an incomplete document.

[TheNurseMan]

Yes, I would speak with your supervisor WITHOUT delay.......

If the orders aren't signed/implemented in a timely fashion, and pt harm should result from a dose not being increased/decreased and/or given/not given, both yourself AND the day nurse could be held accountable for neglect/malpractice. Do you report off to one another when your shift changes? It may be wise to address it with the off going nurse at the BEGINNING of every shift change. Once she understands that she will be asked each and every day if the new orders have been addressed, I'm fairly certain a greater effort will be made to avoid the question all together. If she is understaffed during the day or truly has too much to accomplish, this should be addressed by the supervisor also. Even if the orders have been dumped on you unintentionally, handling the situation for too long quietly may give your supervisor the impression that "you don't mind", and when you are dealing with co-workers, you don't want your helpful nature to become "expected assistance". Hopefully your supervisor will take time to meet with you and the off going nurse (at shift change) to address the problem with everyone present. Please don't delay in speaking up. If your supervisor isn't on your side, it may be time to find new employment. Good Luck!

[engie]

I would confirmed that this is the right order before I will signed it and yes, you are responsible cause you signed it and cannot assume everything is right without double checking it. The Am nurse and Pm nurse should have time to communicate taken over to the next shift what has been going on in order to carry out and continue the task. Being a new nurse, need to be proactive. dont assume that you know. Have a staff meeting and brought that up to prevent from hapenning... Good luck!