Good afternoon my SN friends. I'm curious how many of you have issues getting order clarification from MDs (or suspect a parent may have faked orders). Here is the history.
I have a 1st grader with a hx of migraines, ADHD and behavior issues. In the beginning of the school year, I had to call mom for fevers (2-3x) and migraine (1-2 times). One of the times she had a migraine mom asked if I could give her Tylenol. I explained not without a doctor's orders. Well, about 5 weeks ago, mom comes in first thing in the morning (while I was busy) and dropped off the filled out orders and pharmacy labeled ibuprofen (go give q6 -8hrs for fever). I didn't look at the orders until she left. The orders called for ibuprofen every 4 hours "if has fever". (This parent speaks Spainish only) So, I call the doctor's office on the order to clarify the order AND to ask for the order to read for headache because the way I see it, if a student has a fever, they need to go home, not get medicated and sent back to class. I was placed on hold for 20 minutes. I hang up and call back the next day, again put on hold. I have since sent three faxes for order clarification (since when do we give ibuprofen q4?)... anyway, I can not get the doctor to call back or fax back clarification.
Fast forward to this week. Student throws up in classroom, gets sent to clinic and has temp of 99.4. No, not a fever but student says she's been vomiting since last night and mom gave me medicine when she woke up. We call mom, who says, "she has orders for medication, I gave it to the nurse myself".... I go on to explain that the orders have never been verified by the MD and that while I am happy to medicate a headache (with PROPER orders) I will not medicate a fever (and vomiting) and send the child back to class. I also explained (through my translator) that a child with a fever needs to be picked up because of risk of child being contagious. Mom was peeved she had to pick up her kid.
Did I handle this wrong? What doctor orders medication for fever to be given at school? The mom also lied to the teacher and told her I had orders to give ADHD medications at school-- as far as I can tell (mom hasn't provided me any documentation or meds for anything other than "if has fever"), the child does not take ADHD medications..
Do y'all have trouble getting doctor's to respond to clarification or did mom fake the orders? I'm beginning to think she did.
Ha! I laughed when I read this because it reminded me of a time working at the SNF when we sent out a pt to the hospital and I called later for an update and they told me the pt was admitted with "acute febrile illness"
You all should be ashamed your first duty is to your patient, advocacy is our goal here Q4 ibuprofen is not an order "five rights unavailable" invalid prescription...As far as dosing goes Q4 at 100mg po ibuprofen is rather common for someone suffering migraines. It is your duty now to get the prescription or turn over for prosecution the person that gave it to you. You DO NOT start with the patient or the family the doctors name is on the prescription and your state AG would dance a jig should you send it to him/her federal law imposes that a fax number must be made available to you if not now it is your school districts issue and you turn it over to the principal. However in the mean time a child is suffering and her relief is in your hands.
You all should be ashamed your first duty is to your patient, advocacy is our goal here Q4 ibuprofen is not an order "five rights unavailable" invalid prescription...As far as dosing goes Q4 at 100mg po ibuprofen is rather common for someone suffering migraines. It is your duty now to get the prescription or turn over for prosecution the person that gave it to you. You DO NOT start with the patient or the family the doctors name is on the prescription and your state AG would dance a jig should you send it to him/her federal law imposes that a fax number must be made available to you if not now it is your school districts issue and you turn it over to the principal. However in the mean time a child is suffering and her relief is in your hands.
I'm not sure what this comment is about. I see from your profile that you are a student. Until you have experience with a like situation, please don't lecture those who have experience. It doesn't make for a good start or idea exchange to tell someone how it is when you don't have the experience to back it up. No, I'm not trying to be mean, just giving you a nudge in the right direction before someone else tells you in a less than nice way. Moving on...
You all should be ashamed your first duty is to your patient, advocacy is our goal here Q4 ibuprofen is not an order "five rights unavailable" invalid prescription...As far as dosing goes Q4 at 100mg po ibuprofen is rather common for someone suffering migraines. It is your duty now to get the prescription or turn over for prosecution the person that gave it to you. You DO NOT start with the patient or the family the doctors name is on the prescription and your state AG would dance a jig should you send it to him/her federal law imposes that a fax number must be made available to you if not now it is your school districts issue and you turn it over to the principal. However in the mean time a child is suffering and her relief is in your hands.
You again?
When you work in this type of situation as a NURSE, I would love to hear your opinion.
Your last 10 posts on this board have been disjointed at best and demeaning at worst.
While entertaining, no one here on THIS forum is going to take you seriously.
I do have a soft spot for the fun value a poster like you brings, so I hope you DO keep posting.
To OldDude: only Mexicans speak Spanish right? Not Guatemalans or people from El Salvador. U are a racist demeaning person. Any relation to Donald trump perhaps?
To OldDude: only Mexicans speak Spanish right? Not Guatemalans or people from El Salvador. U are a racist demeaning person. Any relation to Donald trump perhaps?
What the hell? He lives right on the Mexican border, Ms. JudgeyPants.
You all should be ashamed your first duty is to your patient, advocacy is our goal here Q4 ibuprofen is not an order "five rights unavailable" invalid prescription...As far as dosing goes Q4 at 100mg po ibuprofen is rather common for someone suffering migraines. It is your duty now to get the prescription or turn over for prosecution the person that gave it to you. You DO NOT start with the patient or the family the doctors name is on the prescription and your state AG would dance a jig should you send it to him/her federal law imposes that a fax number must be made available to you if not now it is your school districts issue and you turn it over to the principal. However in the mean time a child is suffering and her relief is in your hands.
Sorry, my license is at risk here, and I have 600 students to care for that also need me. I'm not going to give a medication without proper orders. If you read my post, you would see that the orders read for ibuprofen q4 "if has fever". The orders were NOT for migraines. As a nurse (if you are one) do you actually give PRNs for reasons other than what is written on the order? Do you not get clarification on orders that are incorrect?
If my student is suffering, I'm going to do everything within my power and SCOPE to care for them. Giving meds without orders is malpractice. period.
I'd also like to point out that the actual medication filled at the pharm reads q6-8hours for fever, so the actual prescription does not match the orders given to me by the parent... which is why I've been trying to get clarification for the past 5 weeks.
She did or somebody else did. No MD, NP, or PA would write for ibuprofen Q4 and/or to give for a fever at school. Remain firm. Wait for the confirmation, in writing, which you'll never get. You made the right call. And by the way, if it ever comes up, we share a border with Mexico and we don't accept prescriptions filled outside of the US.
To OldDude: only Mexicans speak Spanish right? Not Guatemalans or people from El Salvador. U are a racist demeaning person. Any relation to Donald trump perhaps?
OldDude lives in TX which shares a very large border with Mexico. It's very likely that he has students who travel to Mexico frequently. His comment is not racist in anyway. He is commenting on things that he has encountered in his nursing practice. Please do a little research before throwing a sweeping and insulting judgement his way.
To OldDude: only Mexicans speak Spanish right? Not Guatemalans or people from El Salvador. U are a racist demeaning person. Any relation to Donald trump perhaps?
OldDude did not mention anything about speaking Spanish. He Was referring to prescriptions that are filled outside of the country, which happens quite often in Texas (from personal experience), and I assume nurses in other parts of the country encounter also. Do not come on this board making obscene comments about this nurse or any other just for the sake of bashing someone.
To OldDude: only Mexicans speak Spanish right? Not Guatemalans or people from El Salvador. U are a racist demeaning person. Any relation to Donald trump perhaps?
This has nothing to do with his post, which mentioned not accepting scripts written outside of the United States.
Sadly, I think the Facebook crowd has discovered the SN forum. I'm not a SN, but you guys are special to me, and this gives me a sad.
Kate1RN
2 Posts
And yes I have had parent's add to the Md order after the md completes. I fax it to the doc and ask them to clarify or initial the new additions