gosilverstreaks

In Illinois, the overnight shift was responsible for verifying the newly printed MARs that are for the following day (beginiing with the day shift med pass) with the current MAR they have for the patients they are assigned to. If there are any discrepancies found, it is then your responsibility to go back to the chart and see what the last order was and make the correction. While the Unit Secretary in some places transcribe the new med orders onto the MARs straight fromt he chart, it is the nurses responsibility to verify that the transcribing was done accurately and then sign off the order. Some hospitals have gone away from the Unit Secretaries transcribing any drug orders and the full responisibility for getting the new drug orders on the MAR are up to the nurse assigned to that patient during the shift the order was written.

As an Oncology nurse, we are required to get the consents from our patients prior to starting their chemotherapy. We are not present at the MD visits, so we do not know what has been discussed with the patient as far as their treatment regimen. So, when we approach the patient to get their consent, we give them printed information on all the drugs the doctor has ordered, offer them time to read through the information (sometimes they will take the opportunity to do this, sometimes not, but we offer them that choice), and we answer their questions to the best of our ability. We note on the actual consent form that printed information was given to the patient for review and for their personal records prior to obtaining their written consent. After they have signed the consent, and we sign that we have witnessed their signature, we also note, in ( ), the following - witness to signature only. At least here in Nevada, that gets us through the 'legal loophole'. We can not force anyone to read material that we give them, nor do we have the time to sit in on the MD visits to make sure that all pertenant information has been gone over with the patient and that all of their questions have been answered. If the patient has questions that we, the nurses, are unable to answer, or feel that the doctor is the one who should be addressing that issue, we get the doctor to come and talk to the patient, and not in our nurses notes that 'pt had questions prior to the start of treatment that the MD came to chairside to address prior to obtaining written consent.