If a MD says "Don't Call Back"- do you write that as an order?

[proudnurseRN]

I have had this happen a few times, most often due to pain meds. Pts pain out of control and I've called a couple of times for orders and they have said " she can have this and/or that and nothing else. Don't call me back."

I do write the order. Something as "MD notified of pain 8/10. MS 2-4mg every 2-4 hours prn pain. Do not call back regarding pain control issues. MD will see in am."

Is that appropriate?

[Mulan]

I did something similar once. Never heard anything about it.

That is what he said.

[Tait, MSN, RN]

I would say it is. I sometimes ask them if they just want pain management/anesthesia to see them instead as well if they are getting really bucky with me.

[3dayRN]

Why would you write Dr notified of pain 8/10 in the orders. That is something that should be written in your nurses notes.

[RockinChick66]

I would not write "do not call back" as an order, as I don't think that is approriate, but I would include that in my nurses notes.

[herring_RN, ASN, BSN]

I has asked the doctor, "Don't call me about that. Should I write that as an order?"

Often they reconsider.

Night shift I think they may not be quite awake.

[psu_213, BSN, RN]

Had a pt go into A fib. in the middle of the night. Called the MD, got order for cardizem gtt. At the end of the call he said "oh, and add a Mag level...don't call me back with the results." Now, my guess is that he meant not to call him back with a normal level. I certainly would have called him if the result came back at, say, 1.1. I did not write, the "don't call back part" in the actual order, but I wrote in my nurses note. I expalined the new onset AF, that I called the doc, obtained order for a dilt drip, the order for the mag level and then said "Dr. XX requested that I not call back with the results of the magnesium level."

[Tait, MSN, RN]

Yeah I suppose it makes more sense to document it in the nursing notes. Though there have definitely been times I wanted to put it in the orders lol...

[proudnurseRN]

Why would you write Dr notified of pain 8/10 in the orders. That is something that should be written in your nurses notes.

I probably wouldn't. Actually who knows what I might write depending on what else is going on.

Writing it as a nursing note is probably a better idea. CYA... and the MDs don't read the nursing notes.

And really, if it came down to it, I would call back anyway if I had to for the patient. Or I've also been known to call another MD consulting the case if appropriate and there was a good relationship with that MD.

Just wondering how others handled the "do not call back order."

[Altra, BSN, RN]

In the situation you described, where you have been given prn orders (and range orders at that ... love it!) and the MD has said s/he will see the patient in the morning, I would not write it as an order. I save that for situations in which the MD has indicated that s/he is not interested in working with the nurse for the care of the patient, and I don't get that sense in this scenario.

[AngelicDarkness]

I probably wouldn't. Actually who knows what I might write depending on what else is going on.

Writing it as a nursing note is probably a better idea. CYA... and the MDs don't read the nursing notes.

And really, if it came down to it, I would call back anyway if I had to for the patient. Or I've also been known to call another MD consulting the case if appropriate and there was a good relationship with that MD.

Just wondering how others handled the "do not call back order."

I'd probably write it in the nursing notes too. And the MDs at my facility share nursing notes with us under "progress notes". So if they saw anything like MD "advised not to call back with results" they can elaborate on why or why not. I've never had a "do not call back order" but I've heard of them, and I applaud nurses who bluntly (yet politely) challenge it "Sooo to clarify if that level drops to critical levels you do not want me to call you back? If there is a code called, would you like to know?" Sometimes on nights at the old surgical floor I worked at, if it was a MD known to be rude and accuse the nurse of "calling for dumb reasons", he'd be placed on speaker phone so the whole room could hear. After a few reports, he changed his attitude pretty quick lol.

[nuangel1, BSN, RN]

no i would not write that as an order .second that is not a proper order in my facility .we can not take range orders .i would document in nurses note that md was called.and i would call him back regardless if i needed to for the pt .