did the md's pen go into v-fib??

Nurses General Nursing

Published

ARRRRGGGHHHH!!

oh Geez, hands down the worst part of my day is my hourly chart checks for new orders and having to speak to foreign drs on the phone.

background: we have physical paper charts the docs/pa/np write orders in and it is up to the unit secretary to enter the orders (for approx 55 pts) but if she is swamped/nurse gets there first, the rn enters the order in the computer. the rn is also responsible for confirming the correct written order was put into the computer by the secretary.

problem 1: i cannot read these Godforesaken scribbles. at times, only 1 letter of a word is decipherable, the number 6 looks like the letter H, etc. it looks like their pen went into v-fibb and expired somewhere around the signature where all i see is a couple random zig zags and a loopdeeloo. if i didn't physically witness the md write in the chart, i have little clue which md ordered what. don't they have stamps or something??

problem 2: the vast majority of our drs are talented foreigners mostly indian/iranian, chinese/phillipino etc. calling for a critical value/change in condition and request for a new order is just painful. perhaps it is the phone that is warbling and distorting their english because in person i hardly have this issue. i end up asking for clarification and a repeat like 2x and when i repeat the order back i still mess up the frequency or something unless they say "NOW/ STAT".

i feel embarrassed dumb and annoyed. i have been at this facility for approx 3mos and evidently my coworkers have learned to converse and read the language of MD Vfibb.

some say that if you read the same order phrase/word, from the same dr 10,000 times you start to be able to figure out what they mean. some fill in the blanks and hope for the best. others shrug and say "ummm no clue. if they still really want that order tomorrow they'll probably rewrite it and maybe i can read it that time..."

do your hospitals have the md type their orders into the computer themselves? maybe there is a dr smart phone- nurse computer order entry capability?

this seems archaic and convoluted to me.

thoughts/suggestions??

As time goes on you'll learn the frequent doctor's hand writing. We have a doc who's signature looks exactly like a vfib, but it is very distinct.

I love the ones that use an entire 8 1/2 x11 sheet of paper to write 3 orders lol.

But my Hosptial has give all the docs a pen with a stamp of their name. Only about 2-3 of the docs I see use it.

Specializes in ICU / PCU / Telemetry / Oncology.
some fill in the blanks and hope for the best.

That is clearly a dangerous thing to do! I'd be scared to work with nurses like this!

Thank God my hospital is mostly EPR and new orders popup on the screen and we very rarely have to read a doctors scribble anymore (in fact, I don't even know what my attending's handwriting looks like unless the are completing a death certificate).

This looks like an opportunity for you to devise something that enables MDs to enter orders on computer. Perhaps you could work with your hospital's informatics team to make this happen (electronic order entering)?

Specializes in NICU, PICU, PACU.

All I can say is thank God for EPIC and electronic order sets!

HCA has gone to electronically-entered physicians' orders, but not all providers comply, it depends on the facility's zeal to enforce it. When taking ER admission orders by providers who cannot-or care not- to articulate their words, I simply ask them to repeat/spell out. Often, I just get the same unintelligible sounds, but louder. My response is: "It is YOUR license I am looking after, Sir/Ma'm, not mine." This usually gets their attention. As a foreigner myself, there is NO EXCUSE for not speaking proper English when accurate communication is vital to your profession and when patients' safety depends on it!

Years ago, I worked with a doctor from Egypt. His accent was so thick and he talked so fast, I could literally be standing in front of him looking him dead in his mouth, and didn't have a clue what he was saying. He used to get so frustrated at me, asking him to repeat himself or slow down. Then when he'd get mad, he'd start spitting when he talked, which of course made it even harder to concentrate on what he was saying, lol. After about a year working with him, I could understand every word he said. Apparently it was my fault for not being able to understand him.

Ironically, his handwriting was beautiful...

Thank you for my first "chuckle of the day"!

at times, only 1 letter of a word is decipherable, the number 6 looks like the letter H, etc. it looks like their pen went into v-fibb and expired somewhere around the signature where all i see is a couple random zig zags and a loopdeeloo.

Awesome. Paging the coffee clean up crew to my office now...

Specializes in Care Coordination, MDS, med-surg, Peds.

I worked with a Dr in a hospital setting whose handwriting I could read better if I stood behind the paper and read it upside down!! LOL

Its funny when you ask the Doc to read what he wrote and he can't! SHAME on him/her..if they can't read their won writing how the heck does he/she expect us to.

I had a Dr write an order for social services for placement that to me and the 5 other staff I showed it to, swore it said...stool speciment for parasites!!! We laughed about that one...........later....

Specializes in ED; Med Surg.

We used to have the rubber stamps but that was just for their names after their (illegible) signatures. But we now have (YAY) CPOE, or Computer Physican Order Entry. They have to enter their own orders...they complained before it got started but they love it now. Most of them anyway.

Specializes in NICU, Infection Control.

All the nurses were told to BUY name stamps, the docs were given theirs free. grrr. Guess who used them the most? not the docs.

Specializes in ED.

I love being in the ED for this reason. T-System is my BFF. I have had more than one instance where I was flipping through admission orders, I asked three other nurses, and NO ONE could figure out what was written. I know it's a 500 year old joke about doctors and their handwriting, but I find it less than amusing now that I'm a nurse, even though it does not impact me much. I have bad handwriting but I always make an effort to make it legible, doctors need to do the same.

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

We had a doc who would writer her name in all caps after she signed orders. Luckily the rest of it was easy to read but I always appreciated that, especially when I was a secretary and didn't know who all the signatures belonged to!

This. Having to track down charts to get new orders, or wait for the HUC's to put in orders/do it my self (the ones that are legible) makes me crazy. It is dangerous. It is not expeditious. My hospital will be going to Epic next year, but I don't know if I can put up with it til then.

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