I am sitting here wondering what situation would cause me to use two pages charting about a slow MD/pharmacy taking four hours to supply pain meds. I really can't. If it was that bad, I would call an oncall MD and tell him/her I need to transport a patient to the ER because we are unable to control his pain. If the MD refuses, just make a short entry about it in the nurses notes, transcribe it as a T.O. on the physicians orders page and be done with it. In order to throw away your entry in the physicians orders the DON would have to throw away all the other orders on that page also. If you are not allowed to write T.O.s where you work just make a one paragraph entry with only the relevent facts and call it quits.
Only twice have I been unable to get hold of an oncall MD. When I demanded to be put through to another doctor and told the aswering sevice I absolutely have to talk to an MD (after they insisted there was no one available) it took about 60 seconds for another MD that wasn't even on call for mine to call back. I have never made a two page entry for anything including work place violence, elopements, abuse, --nothing.
It is possible removing that entry protects you as well. did you really take ALL action available to you to provide for your patient? Did you call your supervisor (the DON) about a situation you were not able to resolve?(), how many times did you call the pharmace/ MD. What did you tell them, What else did you do to relieve the patients pain? In your charting were you blowing off steam or sticking to actual facts and not perceptions and opinions?
I have had my DON ask me to rewrite two different entries and after she explained why I was happy to do it. Those rewrites included other nurses having to redo theirs also. My entries made both me and the facility look bad were we to go to court.
But in the end I have to say I totaly agree that what the DON did is illegal. It does happen in LTC/SNFs though. Find another job BEFORE you report it because you are going to need one.