Does a doctor have to write discharge home on an order sheet

[ashland]

I am a Season Nurse, but I was terminated from my position because...I read in the Doctors discharge note, OK to discharge infant when mom is discharged. I discharged the infant. My intent was to call the Dr..but I was stressed and working in a very hosital environment.

[kauainurse]

i thought and still practice that if the doctor writes an order for discharge on an order sheet you may then discharge that patient. If he just wrote it in the progress notes, that is NOT an order, so call him and clarify!! I wish you well.

Aloha!

[Pepper The Cat, BSN, RN]

Sorry - you need an actual order.

Hope you find a new position in a happier place.

[lpnflorida]

yes, a written order has to be on the order sheet, either written by the doctor themselves or as a telephone order received from the doctor by the nurse.

[marilynmom, LPN, NP]

Yes, it has to be a written order.

Sometimes our doc's would forget and I would call and get a verbal order, but an order never the less.

[november17, ASN, RN]

Sometimes a doc forgets to write the actual order to discharge, but will tell me to let the patient go that day. So I just write it as a verbal order before I discharge them. Unless there has been some sort of change between the times the doctor leaves and the time the patient is leaving, I don't bother calling. It depends on the doctor though.

[Ruthiegal]

Yes, you always need an order. Think of it this way, most everything needs an order, verbal or written, even to let the patient burp. I know it's absurd but it will help you remember to check for those orders, and make sure they are there before you do anything that needs one.

Have a Happy and Blessed Easter.

[nerdtonurse?, BSN, RN]

We need an actual order at our place, because I've got two pts who have been signed off on by medical management that they can be DC'd -- believe me, it that was all we needed, I'd have sent them out the door last night...

[ashland]

This hospital procedure is if the Dr.,signs his name on the discharge form that you complete to give to the patient, the doctor does not have to write a discharge order. If that process is ok, what is the difference in the Dr. writting discharge pt, in their progess note.

Sometimes a doc forgets to write the actual order to discharge, but will tell me to let the patient go that day. So I just write it as a verbal order before I discharge them. Unless there has been some sort of change between the times the doctor leaves and the time the patient is leaving, I don't bother calling. It depends on the doctor though.

[Straydandelion]

The hospital IMO is never going to agree that doctor progress notes replace actual orders, you made a mistake and sometimes it is best to admit it and go on from there, however it seems quite stringent to be let go for one mistake. You mentioned "stressed and in a hostile environment" sounds like there may be other issues/problems going on with the facillity too.

[NeosynephRN]

This hospital procedure is if the Dr.,signs his name on the discharge form that you complete to give to the patient, the doctor does not have to write a discharge order. If that process is ok, what is the difference in the Dr. writting discharge pt, in their progess note.

Here is the difference in my opinion. I do not work L&D but in my area often a doc will right "pt suitable for hospice care" or "medical futility should withdrawl life support" in a progress note...that does not however give me any order to "pull the plug" or initiate hospice.

[diane227, LPN, RN]

At my facility they do.