Doctor's lying about telephone order - page 3

I an very upset, mad, devastated, anxious and depressed. I received a TORB from a doctor for 10 mg or medication to be given once. 4 days later patient developed EPS (which is kind of strange... Read More

  1. by   Fleur deLirious
    I've experienced this "cover-your-butt-by-throwing-the-innocent-nurse-under-the-bus" behavior before. I received a patient to the Rehab unit, where we normally would change them from IV/IM to p.o. pain management. This patient's orders still had them on IM Demerol. I called the MD to review the transfer orders and got an order to change the patient to p.o. pain meds. Later that night, after having received said p.o. pain meds, the patient sustained a fall. I came to work the next day to hear that this MD subsequently denied giving me the order. What? I get orders for LESS intense pain management, and you're trying to shift blame? I was incensed. We admitted a lot of patients with telephone order approval on transfer from acute care. I had been a nurse for about 15 years at that time, and had never experienced this before. I was not about to remain silent. I wrote a very professional, detailed letter to administration, outlining the events and stating that I would no longer take phone or verbal orders from this physician without another nurse witnessing the order (as with phone consents). The first couple of times after that when I called for orders, I'd have a nurse next to me listening to me repeating the orders to him, and when I said "I just need you to confirm these orders with nurse Jane", he would say something like "I don't have time for that" and hang up. I persisted, and called back until the orders could be obtained.
    He never did that to me again, nor has any other physician over my nearly 30 year career at the bedside. About 5 years ago, I started seeing him as a consultant on occasion on the Tele unit where I worked -- he was very respectful to me. My advice: Insist. Persist. Resist. You have to protect yourself.
  2. by   sunny time
    [B]after speaking to the doctor record the time. when you chart put the time and in quotes put the doctors exact words. I don't care how fast pace the floor is repeat the order back to the doctor.. if you are not sure read the order from your notes back to the doctor. chart that you confirmed the order with the doctor. if it is the same doctor have someone else (supervisor) call for orders. do not deal with this doctor if you have to. if he comes to the floor and gives a verbal order ask him to write it please and do not carry out the order until it is in writing. this will somewhat protect you but remember cover your own a$$.
  3. by   FolksBtrippin
    Okay, I am going to help you here.

    Doc made a mistake and gave an adult dose to a kid.

    Then doc lied about it.

    Doc attempted to throw you under the bus. However, no bus came. You are completely safe and everyone believes you.
    Repeat that 3x so that you understand. Say aloud, "Everyone believes me. I am safe."

    However this doc is never to be trusted again due to the fact that he is both stupid and a liar.

    Do not take verbal orders from this doc. He must fax orders. That covers you on the liar part.

    For the stupid part, look up any drug he orders and check recommended dosages and interactions.

    You could always report him to the medical board for lying but it will likely go no where and just stress you out more.

    Now that you know how to handle it, let it go. Don't let it drive you bonkers.
  4. by   JKL33
    Quote from FolksBtrippin
    You could always report him to the medical board for lying but it will likely go no where and just stress you out more.
    ...and remind him that he still needs to report you to the BoN for "what you did"...

    Yeah, don't go there.
  5. by   Glycerine82
    Just make sure you always read it back to the doctor verbatim. Ok, So give xyg 5mg now for xyz reason, is that correct? Now they've told you once and you've repeated it once. Makes it harder for them to say they said the wrong dosage.
  6. by   Ruby Vee
    Quote from Glycerine82
    Just make sure you always read it back to the doctor verbatim. Ok, So give xyg 5mg now for xyz reason, is that correct? Now they've told you once and you've repeated it once. Makes it harder for them to say they said the wrong dosage.
    It is my understanding that the OP did that. The doctor still says she's lying. The doctor, it seems, is lying. It's rare, but it happens.

    Years ago, I was a brand new nurse and a physician wrote an order to give a liter of D5W to a patient for dehydration. He actually wrote the order, and the unit clerk took it off appropriately. Pharmacy sent up the liter of D5W marked with the patient's name, and I gave it to the patient, with a poor result. The physician MEANT to write for a liter of NS, and stealthily took the chart off the pile of orders that the unit clerk had transcribed and were waiting for the RN to sign off on and scribbled over his D5W order to write NS.

    This physician wasn't aware that the UC highlighted any pharmacy orders with a yellow highlighter and ran off a copy which she then tubed to pharmacy through the pneumatic tube system. (I did warn you that it happened years ago . . . about forty of them.) As the physician was delivering a blistering tirade to the nurse (me) about the sheer stupidity of giving D5W in this situation and what kind of a moron would DO such a thing, the UC came into the room bearing the copy of the physicians original order -- before he scribbled over it and tried to pretend he'd never written the order.

    The next time he wrote such a bad order, he removed the page from the order book after it had been transcribed by the UC and signed off by the RN. (Apparently he didn't learn the first time.) While he was complaining to his partners about the incompetent nursing staff in this place, the UC presented a copy of the orders, page numbers sequential and the sequence complete with the offending order in the guy's own distinctive handwriting. His partners suggested that he might find the weather in Arizona more congenial and he was gone.
  7. by   Orion81RN
    No advice u unfortunately, but I was in a situation where ut my word against the Dr's. I admitted a pt to post acute rehab, and she claimed a few days later that I did not notify her of of the admit nor verify orders. I very specifically remember clarifying orders bc there were asthma meds on the discharge list with no dosages.

    Anyway I got written up bc I did not state in my progress note that I notified M.D. Big slip up? Yes. But we ARE set up for failure when being given 20 pts in post acute rehab...NOT AND, but completely rehab.

    I DID enter under my admission screen, however, the date and time I had notified her. Didn't matter. They still wrote me up. Such BS.
  8. by   MJB2010
    We have a surgeon like this. Almost no nurse will take a telephone order from him. We put him on speaker phone at the nurses station and a witness (or 3 ) always signs off on it. If a witness is not available, he must fax a written order, which is rare and he throws a tantrum. But we protect ourselves. He has done this more than once to night shifters, yet the facility sides with him.He comes in and denied giving the order, tries to change it, or says we never spoke to him. We do what we have to to protect ourselves. If the facility won't take care of him, we will. No witness, no order.
  9. by   Workitinurfava
    What is the name of the medication? Was it haldol? If so, not sure if you already had an order for congentin but you could have given it. Especially if it is the persons first time taking it. Not blaming you for not doing so but this is a way for you to protect yourself. Benadryl helps to prevent reactions as well.
  10. by   sistrmoon
    I had an MD write a note in a chart outright lying about the calls I made to him and the communications between us. Basically a patient threatened to leave AMA, I called the MD, MD didn't come to the floor right away to see the pt, just said "call me back if he's serious." PT was serious and said he was leaving, paged the dr again and didn't get a call back. Finally got a callback from the Md long after the PT was gone, MD was mad, came up and wrote in the chart that I'd not called him at all until 30 minutes after the PT left(lie.) I'd written my own note and had several witnesses to my initial call, also told the nursing supervisor about it. Nothing came of it but it was infuriating.

    There's a big push for us to only take phone orders for emergencies(pain meds are included in this.) The doctors are very resistant to inputting their own orders though, especially the hospitalist attendings who never seem to be near a computer.
  11. by   DTWriter
    Totally despise telephone orders.

    Chances of miscommunication, especially when both parties have an accent . This person said/that person said... bleh.

    It would be nice if more facilities make it a point to have a witness sign off on telephone orders and/or record conversations with telephone orders.
    Last edit by DTWriter on Jul 16, '17
  12. by   Irabee
    Mom made a big deal over this incident and was threatening to sue. I doubt the EPS was from my shot. because it developed four days later.
  13. by   Irabee
    It wasn't an adult dose. We routinely give 10 to adolescents. Pt. just developed EPS, things happen. But the Dr. decided to put this on me . Thank you for support. I am starting to forget about it.

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