You're right that just documenting the conversation wouldn't let others know about the change in the order. I was attempting to address that issue by suggesting that the nurse should remind the doctor to d/c the order and hopefully he would do it soon enough to prevent a situation like this, but it's not a perfect solution. Given the way this particular situation worked out, the best outcome resulting from documenting the conversation would be to protect the (OP) nurse from accusations by management, showing that she had covered all of the bases as best she could under the circumstances.
I also agree that it's not exactly the scenario for refusing an order, but without a better idea, it's the best I could think of to support the (OP) nurse for not giving the original order.
There does need to be a way to ensure that the order being followed is entered as an actual order, but the nurse's hands are essentially tied in that respect since she has to wait on the doctor to do his part. The whole thing is a bit bizarre to me and a sticky situation for any nurse. Something needs to change, but until it does, I think the only option under the circumstances is to document the whole thing.
