I have my leadership rotation at the med surg unit at one of the hospitals in Chicago. They have some sickle cell patients on the floor but do not have a standing order for the sickle cell patients. The staff asked me to do my in-service about the the standing order for the sickle cell patients. For once, I do not even remember if I ever came across the standing order for sickle cell patients at other hospitals. Where can I get some information about this? What is usually included in the standing order for the sickle cell patients? How does the hospital implement the standing orders? Do you have any links to send?
Where ever I have worked that nursing had come to the conclusion we need standing orders for something it is because we see the doctors ordering exactly the same thing for every patient or every patient with a particular condition.
Standing orders in those cases can make it easier for the physician and nursing to ensure that nothing gets over looked.
So this is how we come up with standing orders. we look back over all the charts of patients with that condition and find the commonalities in the routine orders. Then we go over it with the physicians and with their approval create the standing order.
This usually only happens when there is something that has a lot of orders that are repeated exactly over and over on patients.
Oxygen is a common standing order on nearly all standing order sheets.
IV fluids are on many standing order sheets
But when you are dealing with a cycle cell patient I do not see anything else that could possibly go on a standing order sheet because as already stated many times the pain control meds and dose will be very individulized.
If this does not serve a purpose of making sure things are not over looked what is the point? Creating standing orders just to create them is a waste.
In any case you can not create these order sheets without the input of the physician as it is the physician that will be using it. It is designed to make his life easier.
If it does not he will not use it. You can not compel him to as it is he who must write and sign the orders.
Generally it is a doctor or group of them that write up the standing orders that they want and then request that we create an order sheet with these orders on them so that he can simply just come in and sign it and know that all his orders are on there and he did not forget something.
I believe you must look at the motivation of creating these orders first. Then go to the doctors and ask them what do they want.
I finally click on the link you provided. The problem that was stated is lack of understanding of the pain and psyc issues involved. EDUCATION is what is needed. Standing orders are not going to fix that.
Specializes in Medsurg/ICU, Mental Health, Home Health.
I agree with IV Fluids, oxygen and pain management. I'd like to also add telementry (I know I usually see sickle cell crisis with monitoring if the hemoglobin is low), daily CBC with dff, and heme consult if patient is not admitted under a heme service, and preferably the patient's own hematologist.
Agnus
2,719 Posts
Where ever I have worked that nursing had come to the conclusion we need standing orders for something it is because we see the doctors ordering exactly the same thing for every patient or every patient with a particular condition.
Standing orders in those cases can make it easier for the physician and nursing to ensure that nothing gets over looked.
So this is how we come up with standing orders. we look back over all the charts of patients with that condition and find the commonalities in the routine orders. Then we go over it with the physicians and with their approval create the standing order.
This usually only happens when there is something that has a lot of orders that are repeated exactly over and over on patients.
Oxygen is a common standing order on nearly all standing order sheets.
IV fluids are on many standing order sheets
But when you are dealing with a cycle cell patient I do not see anything else that could possibly go on a standing order sheet because as already stated many times the pain control meds and dose will be very individulized.
If this does not serve a purpose of making sure things are not over looked what is the point? Creating standing orders just to create them is a waste.
In any case you can not create these order sheets without the input of the physician as it is the physician that will be using it. It is designed to make his life easier.
If it does not he will not use it. You can not compel him to as it is he who must write and sign the orders.
Generally it is a doctor or group of them that write up the standing orders that they want and then request that we create an order sheet with these orders on them so that he can simply just come in and sign it and know that all his orders are on there and he did not forget something.
I believe you must look at the motivation of creating these orders first. Then go to the doctors and ask them what do they want.