Refusal to give written drug order

[mactheknife]

Have any of you ever had an anesthetist insist that he does not need to give you a written order to give a patient medication if he is in the department with you? This one claims that if he is present a verbal order is all that is needed. He is willing to sign next to our signature where we record givving the medication and dose and route! Where can I find it in wirtting that all docters orders must be wirren on a docters order sheet and signed by the prescribing docter? We really need all the help we can get.

[tvccrn, ASN, RN]

If you are having trouble with this person, look at your P & P. Not every facility requires a written order if the doctor, etc is present.

[Scrubby]

If I was in this position I would get another RN to witness the order and would write in down on the patient's PRN chart and have the other nurse sign it. This is how we do it for telephone orders. I would also document the whole thing in the patient's progress notes as well.

[FireStarterRN, BSN, RN]

Yes, particularly our cardiac surgeon will not follow policy and will give old-fashioned verbal orders, which he will later sign. The official policy is no verbal orders, it's some new safety mandate made by policy makers who otherwise would be unemployed if they didn't have new idea to come up with to inconvenience everyone.

I will repeat it back for him, write it as a verbal order, and if I can have him sign it while he's still there. I trust him because I respect him, he has earned my trust, and visa versa.

[APRN., DNP, RN, APRN, NP]

A Code Blue situation comes to mind....but the MD signs the code sheet afterwards.

[ghillbert, MSN, NP]

What is your facility's written policy/procedure? This needs to be addressed at the administrative level, not by the nurses having to argue with him. Until recently we were permitted to write "V/O Dr...." and sign "Soandso, RN". Now that we're mostly electronic, it's become moot.. they have to enter the orders via computer.

[JBudd, MSN]

I thought from the title you were refusing to give an already written for drug.....

I would take a verbal and do it, but he has to write the order at some point, not just cosign your giving it. I'll write it myself on the order sheet, with the "v.o." notation. So, yes, the doc has to write something on the order sheet. If there is no trust, he routinely doesn't follow up the verbal with a written, then I would refuse.

Our policy came out they had to write everything themselves first, because there were some docs denying they'd given an order, or saying the nurse got it wrong. So again, I only do verbals with docs I trust.

[highlandlass1592, BSN, RN]

Others have posted that you should check your policy and procedure books. I'd also recommend you check with your BON. Many states have it that you don't have to take a verbal order and actually, reducing these types of order due to inaccuracy is a JCAHO mandate as well. However, all that being said..you may never be able to get this MD to change. You could also take it up with your clinical affairs dept, they deal with credentialing of physicians at your hospital. Just be aware it all may be a losing battle depending upon the type of facility you are at. Good luck.