Appreciate all the posts, eye opening definitely. What it all comes down to was what is best for patient care, and the rationale for implementing this system? After reading through all this, it's hard to have a concrete answer when we all come from different situations, laws, states, and hospital systems. So yes, there is a lot of variety and something that may not be a big deal one place is against policy at another. My main frustration is the lack of time to prepare, we are slammed all the time and I am lucky if I can take the time to navigate through the chart, which in some cases the H and P isn't even put in yet. Not super helpful. But with enough warning and time, it's ok. Our ED gives meds and doesn't document in the MAR, that is a detail they would give in report. It seems like so many things can get missed. Also like someone mentioned, sure I can call with questions but chances are there isn't a whole lot of time to try and find the person that sent up the patient. Just have to figure it out as it goes I guess. As far as IVs go, I start them very frequently, it's not a matter of not being able to do it it's a matter of having fluids and IV Abx due, not having access if this patient codes and the time constraints of starting an IV sometimes.