Legal issues regaurding pitocin augmentation

[medorn]

I work with a Dr. who frequently admits pt's over the phone and wants us to start pitocin before she has ever been to evaluate the pt. The pt hasn't been consented and we don't have written orders. There have been times when I have stated that I'm concerned and she states that she will consent the pt over the phone. Can you legally consent the pt over the phone? Can you take a TO for pitocin augmentation? Most of the nurses I work with refuse to with this Dr. I'm just wondering if there is a way to cover myself and accomidate the Dr. In other specialties you are allowed to take TO for drugs that could be considered to have equal or greater consequences. This same Dr. frequently orders the RN's to restart the pitocin after uterine resusitation without re-evaluating the pt. If I document very clearly our conversation and the pt's condition does that cover me legally? Any advice or clarity regaurding our legal responsibility during pit aug would be greatly appreciated.

[RNnL&D]

What do you mean consent the pt over the phone? Does your admission consent not cover all obstetric interventions?

And yes, we do take verbal and phone orders for Pitocin. Are you talking about pts sent in for induction or laboring pts not progressing? Many docs don't come in for a "put their hands on the pt" assessment. They rely on the nurse's assessment.

[Altalorraine]

We are not allowed to use pitocin without an attending on the floor.

Altalorraine

[htrn]

We do pitocin inductions and augmentations all the time. We take telephone orders from MDs for this all the time as well. We do not do a specific consent for pitocin induction, even for VBACs, just our general hospital admission consent. We do, however, have them sign a procedural consent for cervidil induction.

It's gotten better, but sometimes our patients come in without realilzing they would need an IV or that there is a possibility that the induction may not work and they would have to come back again at a later date. If there is a problem, we will turn off the pit., but our docs are really good about coming in and looking at the strips if we ever have any questions.

[medorn]

Our admission consents do cover OB procedures but there is a seperate anesthesia and blood products consent, these are signed upon admission. I feel these need to be signed and consented by the Dr. prior to the start of pit aug because as we all know things can happen quickly once you have stared pit and you can be in the OR before you know it. Thanks for your responses!

[RNnL&D]

Our admission consents do cover OB procedures but there is a seperate anesthesia and blood products consent, these are signed upon admission. I feel these need to be signed and consented by the Dr. prior to the start of pit aug because as we all know things can happen quickly once you have stared pit and you can be in the OR before you know it. Thanks for your responses!

I'm still a little confused. So the docs get consent for blood products and for anesthetic? Our OB consent states condition: pregnancy, procedure: delivery and care of baby. That can be any type of delivery. They also include an I consent or an I do not consent for blood products check off.