I Hate Surg!!!

What an idiot!!

I should add that obviously I didn't guess a dose, and ended up getting a hold of another member of the surgical team, which wrote for a safe dose to be given.

Doctors seem to be getting lazier and lazier. I am getting more orders for "Medication X---have the pharmacy dose it." On the other hand, this is probably safer for the patient.

Doctors seem to be getting lazier and lazier. I am getting more orders for "Medication X---have the pharmacy dose it." On the other hand, this is probably safer for the patient.

How is that legal?

Wow - I can see where that would be a BIG problem!

Talk about passing along the buck.

How is that legal?

A wee bit off topic but it is legal for a pharmicist to dose a medication based on numerous factors such as pt age, ht/wt, renal function and peak/trough levels. We see this most with antibiotics because the pharmacists know the med doses based on the peak/trough way better than the docs do. Also, we see docs writing orders for Lovenox but then pharm changes the dose based on the pt's creatinine clearance. It really is safer for the pt.

Well gee thanks Dr. So-and-So.

LAST TIME I CALL YOU!!

Next thing you know he will be wanting you to perform surgery or something!

How is that legal?

That's what they're trained for. I think they have doctoral degrees in it - DPharm.

What's the proper role of the RN in this? Obviously it s/he should never guess - that's one crazy doctor for suggesting it but what is with the heavy emphasis on drug dosage calculations in nursing school if not for these type of situations?

What an idiot!!

While frustrating (and where was he coming from, what was his point he was trying to make, or does he always act that way), its not that hard of a situation to deal with. He did give you permission to write a verbal order. From there, just let your nursing skill take over.

Check allergies. If none, get out your book and call pharmacy. If you want, you can even write a pharmacy consult. I would suggest that actually. Write a pharmacy consult for "management of morphine dose/pain control". Nothing wrong with it, its kosher.

Let pharmacy run its checks, check them against your book and there you have it, morphine safe to give.

"Let pharmacy run its checks, check them against your book and there you have it, morphine safe to give." -ericksoln

Wouldn't you rather facilitate the pharm and the surgeon, or anesthesia to figure out? I'd want a completed order in the end from that doc before I give, even if it's verbal again...

"Let pharmacy run its checks, check them against your book and there you have it, morphine safe to give." -ericksoln

Wouldn't you rather facilitate the pharm and the surgeon, or anesthesia to figure out? I'd want a completed order in the end from that doc before I give, even if it's verbal again...

Eh, depends on the culture of your hospital/unit. Some places want you to practice autonomy, others want everything by the book.

My first hospital, the one I learned at, was heavy on autonomy. Doctors didnt want phone calls about diet order changes and things like that. They liked rounding at our hospital because the unit ran so independently.

Other places I've been, they want everything by the book, down to getting an order for the fan being placed in the pt. room.

I dont think either way is better/right or wrong. Just, different ways to swim.

In this case though, I'd be concerned about the pain not being addressed. I'd have pharmacy help me out and double check everything so I could get the pain relieved ASAP. Calling again or waiting for the doctor to round could mean the pt.'s pain going untreated for a long time. Not good.