should MD and Nurse phone orders and phone reports be voice recorded?

[dutchgirl123]

I sat in on another Pharmacy and Therapeutics meeting in our hospital. I listened to the MDs complain (once again) about the calls they receive from nurses, pharmacists and techs re: clarifying orders that were written illegibly or in an unsafe manner. For example "resume all pre-op meds". Also, they are also having difficulty with nurses refusal to take verbal orders. And they don't like the telephone order protocol either (because they don't have time for all that "nonsense".

The Director of Nursing Practice, and the Chief Pharmacist ONCE AGAIN relayed to the doctors that the staff have specific guidelines to follow if the orders are written in an unacceptable manner. And they also mentioned to the docs AGAIN, that nurses and pharmacists are NOT doctors and we cannot do this for them. After the physicians left the meeting, the remaining pharmacists, nurses, resp therapists had (AGAIN) a discussion about the physician's non-compliance and laissez-faire attitude in this matter, which causes a lot of work for everyone else.

Of course included in the discussion was the manner in which the physician attitude is frequently relayed to the person seeking the doctors counsel. And the attitude is often fairly UNPLEASANT and in some cases abusive.

SO...... why aren't we handling all patient related conversations on special lines to record, or convert to text, and time and date stamp these crucial communications? A lot of other less crucial businesses do it.

I believe hospital nurses and pharmacists and therapists taking these orders need this protection. And the PATIENT needs protection from me, possibly writing the wrong order. (because i'm NOT a doctor!)

Why do we continue to take the blame, abuses, and secretarial duties dished out by doctors, without demanding some action? We should have ALL of these communications recorded by a third party electronic device.

Perhaps there would be no more "he said, she said"...because we all know who wins that argument....

[tyvin, BSN, RN]

Can you imagine the department that would have to be created to scrutinize and monitor these calls. Talk about extra paperwork. If a nurse can't handle a doc then the nurse needs to get with it. Doctors expect RNs to have brains and I've seen many that don't have that certain aspect. Also the doc has to be cooperative. It seems inservices to address this would be more of a frugal idea then spending bunches of money for a physician's Watergate. I see a whole can of bad worms with this idea.

[LouisVRN, RN]

There could also be a lot of HIPAA violations or definitely the potential for. Granted really no different than medical records but still. Also while I wish a lot of our physicians would be more cooperative and understanding we all have a job to do and if they feel the need to be grouchy in order to get it done I just try not to take it personally.

[worked hard and long]

I have seen Docs share pt info on their PDA's, Radiologists have images sent to their home when they are on call (so they dont have to come in) There has to be technology out their to benefit nurses. To the first reply I believe the problem arose out a "FRUGAL INSERVICE" which the docs BLEW OFF. And to the second reply why is abuse acceptable? If the role were reverse and the RN dissed the doc you know there would be hell to pay. If a radiologist can and does view images at home why cant the Doc use a dedicated computer where the Doc can view orders on computers at home or PDA while Rn/ PhD at hospital review orders together and Doc d/c or renew orders with his electronic signature OR texted orders entered via Doc while phone conversation takes place. This will probably not happen because nurses are worthless. A nation wide strike might show Docs how much RN,s really do.

[Flo., BSN, RN]

This is why we need physician order entry. Then everyone would be able to read the orders and the mds will not be constantly called to clarify the obscure and hard to read. Of course when they tried to do this at my hospital the mds refused stating that they did not go to med school to be a secretary. They were not hearing anything about patient safety or efficiency.

[That Guy, BSN, RN, EMT-B]

Yeah I'll pass. I already have enough people cramming their heads down every orifice of my body scrutinizing every action I make. The last thing I need is someone recording all my conversations with docs on top of it.

And No I have nothing to hide, I just find it ridiculous and silly.

[jjjoy, LPN]

This is why we need physician order entry. Then everyone would be able to read the orders and the mds will not be constantly called to clarify the obscure and hard to read. Of course when they tried to do this at my hospital the mds refused stating that they did not go to med school to be a secretary. They were not hearing anything about patient safety or efficiency.

Yeah, physician order entry hasn't gone over really well where I'm at either. The physicians get to experience the tedium of sorting through whatever med info system is in place. If the system were well-designed, I'd be all for it, but it's not. At least maybe the hospital will listen to the physician complaints about the system, though, and try to make some changes... I can hope, can't I?

[worked hard and long]

Dear that guy My suggestion was that orders were reviewed and continued or canceled at the same time the doc and rn viewed order entry together. Kinda like you can talk and surf on I phone. Not that recording need to take place but the doc can view ALL orders BY other physicians and d/c with the doc electronic signature. WE ALL know docs grumble about the other docs orders but DO THEY EVER TALK TO EACH OTHER - NO they put us in between! i hope you empathize with your pt about every orifice since that is what you do!!!!!

[gonzo1, ASN, RN]

This is why I will never work any unit except ER. My doc is right there and can clarify. And then I get to chide him about his bad handwriting

[tyvin, BSN, RN]

Just because you're not getting the response you so hoped for doesn't mean you should get your orifice in a twist ... I know you're shocked and bewildered that such a great idea is ridiculous to some of us; be cool.

[Isabelle49]

One of these days, the hospitals and pharmacies will get smart and provide the physician a medication order set, so the MD can initial what drugs, dose, route, frequency they want and sign the form. All of the information will be clearly printed and can be data entried. Would reduce errors and phone calls.

[Little_Mouse]

If no one wants to record a TO or MD's don't want to enter their own orders, what about if MD's TYPED their orders? If there was a program that they can type into, send it and the staff will be able to access it? Even remotely, like if an MD were called and they can send it from anywhere, sort of like an email? At least we don't have to decifer their encryptions...