Accepting verbal orders from another nurse? - page 4
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
Mar 20thanks for the update,you are not there to be popular,you are there to do your best for the patient,forget about that bimbo.
Mar 20We are not supposed to take verbal orders for just about anything unless it is a code or an RRT and then we are supposed to track down doc or resident to get them to place them.
You did right. I would have never have given a medication like morphine without a written order let alone a verbal from a nurse who took a verbal. that is an accident waiting to happen and if you are the one giving it, it is on you.
Mar 20Morphine?!? As they say in TX, 'Hail no!'... I would never, ever, give that on a verbal from another nurse (and when it's not in the system).
Mar 21Glad you talked to your manager and all is well. You did a good job.
I too would never take a verbal order from another nurse. Heck, I push back on taking them from physicians due to the high likelihood of errors! I will take a verbal in three instances - RRT/Code Blue, physician will contaminate the keyboard or keyboard will contaminate the physician. Otherwise no. And a verbal from another nurse...just picture trying to explain that one in court and you will have all the answer you need, whether its a narcotic or not.
Wishing you well as you grow and develop in your role. You have good instincts. This was a valuable learning opportunity.
Mar 21No, you are not wrong. You can't take verbal orders from another nurse.
I would tell her to enter the order before I would give it. Or, say, I'm sorry, I'm not comfortable doing that, and offer to help her with something else.
She knows better, and is cutting corners.
Mar 21You did the right thing. This person can go sit in a fire ant pile for being so unreasonable.
Mar 21You did not do anything wrong, but if you did override the Pyxis to get morphine out...it could be a problem. This is going to get flagged by pharmacy and could be seen as drug diversion or suspicious activity.
The place I used to work at ... nurses could take verbal orders, but it was not seen as a reliable one. So normally the doctors would chart the orders into computer too, after giving a verbal order on the phone. Then you wait for the order to show up in the computer and then pull it from the Pyxis to give to the patient. If this was an emergency, then it would different where there would be verbal orders and you would over ride the Pyxis to get the medication. Plus, there would be a person designated for documenting in that situation.
Sometimes, I would write a verbal order that the doctor gave me and fax it to the pharmacy. It would take about 5 minutes for the pharmacy to enter it into the computer and then I would pull the medication then. So if I had to do something and needed another fellow nurse to help, they would see the order if they were covering for you during a break. They would know exactly what to get and how much. If they wanted to clarify the order with the doctor, they could if they wanted to.
You need to follow up and make sure that float nurse entered the verbal order and scanned the medication for the patient. Did you witness her giving it?
What did the other nurse say who was receiving report from that nurse?
Be careful and be a little more cautious before going to the Pyxis. If you are on orientation still, then bring it up to your preceptor. You need to protect yourself and just because you login, doesn't mean they don't track what comes in and out. She used you to pull out the medication, and all that matters is that the pharmacy sees your name for pulling it out when there was no order at the time. Yes it can be rectified with her putting in the verbal order and scanning the medication, but it doesn't change that you took the medication out for her without an order. If the order was already entered and pharmacy verified it... you pulling out the medication wouldn't look so suspicious then.
Sorry for the detail and none of this is meant to offend you.
Okay, I answered too late, but good that it worked out for you. God job!Last edit by Qing on Mar 21
Mar 21First, verbal orders for me are reserved for life threatening, emergency situations. If no one's going to die in the next five minutes, I believe there's enough time to enter the order for everyone's protection. May I also suggest that you review your hospital's policy on verbal orders so the next time someone asks you to do such things again, you can refer them back to the policy.
Second, never give any meds you didn't prepare let alone administer them to patients you know nothing about. Never put yourself in a situation where the patient's safety is compromised just because the other nurse wants to go finish the handover and leave. It's your license and the patient's life on the line.
Mar 21Good everything worked out well for you, so easily could have gone the other way. Good lesson learned, trust me, it won't be the last one! You're doing great, welcome to The Team!
Mar 21Nope. You did the right thing. It's one thing to give a med for a nurse when it's in the system. No way I'm going to enter an order and give a narc with NO information.
Mar 21Never pull a narcotic without a written order.
Never take a "verbal order" second-hand
Never push a medication someone else has drawn up in a syringe.
And never let someone else waste leftover narcotics you pulled.
Simple rules to go by. Simple rules to keep your license safe.