Medical Assistants and MD orders

LuxCalidaNP · Oct 26, 2009

I used to work as an MA and manage a team of them. We had a problem with this, and unless with was confirming an ALREADY written order (i.e. refill of medications from Pharmacy), it HAD TO BE WRITTEN OUT and signed off by all parties. We were on EMR, so this was a little easier. Things improved greatly after that.

flightnurse2b, LPN · Oct 26, 2009

i am not sure what type of setting you work in but i absolutely would not take an order from anyone but the doctor themselves (i work in a hospital). i am responsible for transcribing it in the chart and then giving the patient that medication or treatment or whatever, and my name is signed that i spoke with the doctor. if it was a mistake, my license would be in jeopardy.

we often have issues with direct admits with orders scribbled out and doses are incorrect or medication frequencies are wrong and we have to call the doctor to clarify bc the doc's handwriting is sloppy. what if the MA reads it incorrectly and you take it over the phone as a TO? i would rather be safe than sorry and hear it from the prescriber's mouth, nothing against MA's, i would be hesitant to take a telephone order from anyone but the doc.

prowlingMA · Oct 26, 2009

I am a CMA and always fax a signed copy of any order to the RN at the hospitals.

systoly · Oct 26, 2009

Have them fax the orders. You'll get a hard copy and a signature at the same time.

wooh, BSN, RN · Oct 27, 2009

The only time I take an order from a non-prescriber (MD, PA, NP) is if the MD is scrubbed in for surgery, and will take it through the OR nurse relaying between us. I don't like it then, but you can hear in the background them actually relaying the information back and forth, so I'm comfortable with it.

Verbal/telephone orders are precarious enough without having someone from the office in the middle of them. I don't care who works in the office, whether they're an MA, LPN, RN, if I call the doctor, I'm calling the doctor, not their office nurse or MA. I used to have a problem with an eye doctor that would try to have the receptionist give us orders for dilation drops, and would complain "well the NICU lets us do it." Well, that's their licenses, not mine. Get the doc on the phone, or the eyes won't be dilated when they get here, it's as simple as that. If I absolutely NEED an order from a doc, and they won't get on the phone, that's what the escalation process is for.

mc3, ASN, RN · Oct 27, 2009

I work in home health, and I can say I have never been allowed to talk to the doctor directly regarding an order. The receptionist won't put me through to them - they put you through to the MA's even when I ask to speak with the office nurse. The MA's are the ones doing the screening. They take the info. and then call me back and say "I have new order from Dr. X for such and such". I then write it up and my office faxes to the doctor to sign. Many of these are for PT-INR's and adjustments on Coumadin. The doctor call me directly back with a coumadin order? Ha ha... It's the process in the middle - of me taking the order from the MA, writing it up and then faxing to the doctor that bothers me. The MA is, in a sense, relaying the doctor's order. There is no way the doctor would come on the phone directly to give any order directly to me. Just like when the MA calls in a prescription refill. The doctor doesn't actually make the call, the MA does. Same thing, right? I do not like this, but it seems it's the way it is now no matter what doctor I deal with. BTW, I find that, most of the time, the MA's seem insulted that I am asking if they are an LPN or RN also (sorry, MA's but I'm only telling you what my experience has been.)

Again, how does everyone else handle this?

mc3

CNM 26.2 · Oct 27, 2009

I also used to work in home health and I had it out with a doctor once because his receptionist called in an order because it was so obscure, I told her I needed to either talk to the doctor or the nurse. They were both busy so she said they would call back, the doctor called me back and yelled at me for ten minutes telling me that as long as it was someone in his office he could delegate ANY task or procedure to them that he saw fit. I calmly listened to him and then told him that my license was on the line and I was not willing to sacrifice it just to save him the time of signing an order. I then told him the order that I rec'd which was this....."Jane's family just called and said she fell and now they can't wake her up, we need you to go out and draw a CBC." I instructed the receptionist to have them call 911 and that we did not provide emergency care such as this...they needed an ambulance. She apparently went to him and told him that I refused to take the order. He became very quiet at that point and later apologized and was glad I questioned the order....as it turned out, the patient had had a fall (which really wasn't a true fall but her family was unable to complete a transfer and had to ease her down to the floor) and she was also having more fatigue than usual and they felt that the two were related......so, from that time on we had a policy that we could take a telephone order from a NURSE but we had to have a follow up signed order from the doctor within 24 hours and if a nurse was not available we needed a faxed order from the doc.