A few weeks ago a nurse was fired for writing a doctor's order. The order was for an OTC medication. When the doctor found out she wrote the order without asking him, he called the state nursing board and JCHACO. State board took this nurse's license away - permanently. JCHACO is "investigating" (going over charts, etc. etc.)
Management tells us to call the doctors for ANY order, no matter how "trivial". A few days later we're told "Well, you know that he (the doctor) never fills out the pre---- orders, but you know what he wants...." Or else you're advised to go to a unit where the doctor is well-known and the nurses there will tell you what boxes you should check - based on the doc's preferences/habits.
Ok, so here we have mixed messages.
I want to stop writing orders for the doctors who are too lazy to call you back, for the doctors who tell you "You know what I want". So I started to call them ("Dr.--, you wrote transfer orders. Do you want to continue the same meds?")
Many nurses say they will continue to write the orders for the doctors they know well, those who will not raise a stink about it. So I'm now in the minority, I'm the "stick in the mud", and I feel torn. What would you do?
We haven't heard the hospital official position on this dilemma. It does appear to me, however, that they're not willing to sit with the medical staff and tell them to start doing their job. I'm sorry, but I do not believe for a moment that a doctor will stand behind you if "something" should happen. The way I see it, when push comes to shove, the doc will stand behind you to kick your behind in order to save his/hers.
Sorry for the long post. What do you suggest I do?
What may help is just in case orders. I worked on an Oncology floor prior to the ER and learned alot from those nurses. They pre-plan for emergencies and side effects. Now in the ER depending on patient acuity-so do I.
I get pain meds for mild, moderate and severe pain. I get benadryl for itching. I get tylenol for headache and fever. I get a maalox order prn for acid. Nausea medication, and anything else I that relates to my patients health. If my patient is NPO for a test, I get a diet for when the test is completed. My meds and drips have parameters- I hate calling doctors-I keep my need to do so at a minimum.
ER is a little different, we can initiate alot of standing orders and always have someone on site in case of emergency. Maybe you need standing orders on your floor.
MAISY, RN-ER, BSN, RN
1,082 Posts
What may help is just in case orders. I worked on an Oncology floor prior to the ER and learned alot from those nurses. They pre-plan for emergencies and side effects. Now in the ER depending on patient acuity-so do I.
I get pain meds for mild, moderate and severe pain. I get benadryl for itching. I get tylenol for headache and fever. I get a maalox order prn for acid. Nausea medication, and anything else I that relates to my patients health. If my patient is NPO for a test, I get a diet for when the test is completed. My meds and drips have parameters- I hate calling doctors-I keep my need to do so at a minimum.
ER is a little different, we can initiate alot of standing orders and always have someone on site in case of emergency. Maybe you need standing orders on your floor.
Hope that helps.
Maisy