Pre-signed Rx pads

[anticoagulationurse]

For those of you working with docs who still use paper hand-written prescriptions, anybody work with a doc that pre-signs their Rxpads and has the nurses write out prescriptions via telephone orders?

[anticoagulationurse]

Really? Nobody?

[WSU_Ally_RN, BSN, RN]

I have seen docs give presigned rx pads to their PA, so when the PA discharges a pt, they don't have to run all over to find the doc, but I've never seen this for nurses to do.

[traumaRUs, MSN, APRN]

It's against the MD and RN practice act in IL and is definitely very poor practice.

[Vida]

During my lpn consolidation on an palliative-oncology floor the Dr would pre-sign death certificates before he went home for the day. Oooh he was such a jerk.

Vida

[Altra, BSN, RN]

I don't know how common this is in office settings, but this is definitely poor practice. The state board of medicine, BON and/or the DEA would have a field day ...

If you're the nurse who is being asked to do this, I would suggest that you don't.

[anticoagulationurse]

Actually, I turned the doc in to the state. It was ridiculous. It took one full time nurse to be sitting at the nurses station constantly in order to answer the phone when he would call out from a patient room and quickly rattle off a list of meds. No time to verify (he would get snippy if you interrupted), no time to document the refills in the chart, and before you could write them all out he would flit into another patient room, never looking once at the RX's. The patient would wait for the nurse to write them out and pick them up at the nurse's station. More than one mistake happened with these "off the record" RX's, as you can imagine. It took another nurse to answer call backs for RX clarifications from the pharmacy on the written RX's, and the rule of thumb was "Whatever they were taking last time... yeah that."

So, being employed by him, I refused to do it. Apparently I was "the only nurse in 30 years to make a stink over it." I would comply with his request to write out the RX's for him. But I refused to use a pre-signed RX pad. I would carefully write out what I could decipher from his telephone order and then hand him the stack when he came out of the room, theoretically to review them before signing. He would grab them, not look at them, and sign them quckly and hop away to the next patient room. Still, unsafe practice. It didn't take long before he refused to work with me and I with him and I quit the job.