Accepting verbal orders from another nurse? - page 3

I'm a new RN a little over a month into my orientation on a busy med/surg unit. Tonight at a few minutes before the end of my shift I had finished reporting off and was sitting at the nurses station... Read More

  1. by   sevensonnets
    Oh no!! Klone's right, that smacks of diversion because it was diversion. She could've gone to any experienced nurse with that request but she picked you because you didn't know any better and she knew you'd fall for it. All she had to do was feign 'outrage' and you handed over the morphine. She won! Now you have to convince your manager of that.
  2. by   Here.I.Stand
    Uh... you used correct practice to prevent safety violations!! THAT is being a team player!! I mean nursing school 101 -- you cant check ANY med administration "rights" with nothing to check the drug against. Plus, mere telephone and verbal orders aren't supposed to be done; the nurse is supposed to READ THE ORDER BACK. You can't do that here.

    I'm not typically one to worry about losing our license. BUT, if you practice medicine AND pharmacy you WOULD lose your license. No order: practicing medicine. No verification or dispense: practicing pharmacy.

    So anyway, heck no. The physician really should enter the order him/herself. A distant 2nd option is for the RN to enter it -- only if the MD is busy with a true emergency.

    Sorry for all the caps... this nurse irritated me.
  3. by   JKL33
    Another thought: Personally in most instances I wouldn't even enter a verbal order that another nurse took and I didn't hear. Why? Because I don't think it's an overall good thing. About the time that becomes acceptable practice on a unit then I have lost the ability to control or even have knowledge of what all people might use my name to enter for patients I know nothing about.

    In other words it's going to get bad for each one of us, eventually, if someone else can say they are acting upon (entering "for us") a verbal order that we supposedly took. They can do that if we have no knowledge of a situation.

    Agree w/ klone and others regarding the fact that your pulled med is unaccounted for.

    Best wishes getting this sorted out ASAP....give us an update!
  4. by   Meriwhen
    The only verbal order I'll take is one that I took directly from the provider. If another nurse wants to pawn a verbal order off on me...well, let the other nurse first enter it into the EMR and sign under THEIR name as the one who took the verbal order from the provider, and then we'll talk about whether I'll give the med.

    The only exception to this might be if I was a witness to the verbal order. Even then, that's debatable.
    Last edit by Meriwhen on Mar 20
  5. by   Have Nurse
    Nope. This has nothing to do with being a "team player, " Darlin. You did just fine. And, you KEEP protecting that license.
  6. by   Footballnut
    I expect everyone to put in their own orders unless it's an emergency situation. I even wrote up a physician who became upset because he wanted me to put in his orders even though he was standing right by a computer. We have a strong policy in our hospital. The less an order is passed around verbally, the less chance of an error.

    You may have gotten played but kudos to you for standing up in this situation.
    Last edit by Footballnut on Mar 20 : Reason: grammar
  7. by   Crush
    I only enter an order for a narcotic in an emergency and at that only if I directly got said order from the physician w/ a good read-back. 99.5% of the time the doctor is the one who puts in the orders. As mentioned, the less verbal orders there are, the less chance of a mistake happening.
  8. by   amberrenae, RN
    Update! I talked with my manager, who went into the patients record and saw that the nurse had put the order in and administered the dose a few minutes after the incident. She thanked me for letting her know and for not giving the med without an order, and said that this nurse is very experienced and knowledgeable but this wasn't the first time something like this had occurred with her.

    Thanks all for the advice and support, this has definitely been a nerve wracking but valuable learning experience for me.
  9. by   psu_213
    Quote from klone
    PLEASE talk to your manager about what happened TODAY so that you do not get implicated in this.
    Totally agree. You were definitely right in not giving the med; however, the issue now becomes that you pulled a narc that you never gave. Talk to your NM now and explain the situation before someone raises a stink about a missing vial of morphine.

    ETA: I posted this before I got to the OP's comment right before this. Glad it worked out! In the future, see the order/MAR first and never let someone give a narc that you pulled out (at least not without witnessing them).
    Last edit by psu_213 on Mar 20
  10. by   caliotter3
    That was a close one. Glad you came out on top.
  11. by   Ruby Vee
    Quote from MunoRN
    I normally wouldn't have a problem putting in a order for a nurse that they were passing along to me, I just put per so and so in the order, but the situation you've described is messed up.

    She had you taking out an opiate by overriding it on a patient who had no order for it and at the end of your shift, which pretty much checks every check box for actions suspicious for drug diversion, and then to top it all off she takes it from you to give herself which means there it won't even be charted under your name, there's pretty much everything wrong with that.
    And you've checked the opiate out of the system but haven't administered it. That's another red flag for diversion. If you haven't already, write yourself an email describing the situation as factually and as accurately as you can. Email it to yourself so you have a dated and timed copy. I'm on the fence about whether you should email it to your manager and/or pharmacy.
  12. by   cleback
    In outpatient world, nurses give verbal orders on behalf of the provider very often... sometimes followed up with a faxed order that is properly signed.

    But in inpatient world, I would not, particularly with medications, particularly with narcotics.
  13. by   Leader25
    You did the right thing,if she is from float pool then she could ask the ANM to do it ,it still requires an order.Dont mess around with narcotics and stupid nurses.