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Signing for physician-Standing Orders/Verbal Orders?

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by pulm202019 pulm202019 (New) New Student

Specializes in Pulmonary (IP/PH/Sleep).

I recently took over a clinic in a very large facility. The physician is the only one in the region which means we have tons of patients and tons of order, DWO's, etc. The previous MA had been signing all of these with expressed permission and desire for her to do so by the physician himself. I was directed to continue this practice. It's always been in the back of my mind that It isn't how things should go.

I want to make it known that I am NEVER actually giving the orders. The things being signed are directly ordered by the physician and is documented as so in office notes or from previous orders. The things being signed are renewals, refills (non-controlled only- inhalers, diuretics, etc). I always check to ensure that the most recent notes or documentation does NOT order them to d/c the med or service and I always ask for clarification if I am unsure.

I am just nervous about the actual act in me signing the order with the physicians signature. Should I sign my name even if it says 'physician signature'? I was told by another MA that it was fine if I signed the physicians signature and then initialed, dated and timed the signature as well. We are in Kentucky. I don't know were to look for actual information on this so I am hoping someone can help.

Thanks in advance :)

Contact the Board in writing and request they provide a determination.

Enarra, BSN, RN

Specializes in Ambulatory Primary Care. Has 9 years experience.

I wouldn’t do it because MA, PCT, Cna, LPN, RN Are not allowed to prescribe Nor diagnose and signing someone else’s signature is forgery on top of it all. You can get in a lot of legal trouble. Tell your doc that you are not comfortable signing his orders as you are not qualified to do so. Etc best of luck

Closed Account 12345

Has 14 years experience.

Signing another person's name and physician title is forgery and criminal, even if the person told you it's OK, even if your employer tells you OK. You could face more than the loss of your MA certification if things go wrong- significant jail time and fines.

If one thing goes wrong with a patient on an order you've signed AS the physician by means of forgery, that doctor will throw you under a bus so fast... Stop this practice before the bus runs you over!

As nurses, we can document RBVO(read back verbal order) or RBTO (read back telephone order) by Dr. Smith. I've never worked in a place where MAs are permitted to accept or record any new orders, so I don't know the legality/general acceptance of the practice. What does your employer's written policy say? What does your state regulating agency say? IF you know that MAs in your state can legally accept and record new orders from physicians, I would do what you said by making it very clear that he is the one ordering, but YOU are the one signing.

Example: Verbal order from Dr. John Smith received at Date & Time, signed Your Name and Title

Example: Standing order from Dr. John Smith, signed Your Name and Title

Another concern based on your post is that mentioning a treatment plan in a physician's note is not and order nor a prescription. Are you ever receiving *actual* verbal or written orders for these refills? Are there written standing orders signed by the doctor in place that say medical assistants can refill certain medications? Although they're not controlled substances, diuretics require ongoing patient assessments and periodic lab work to be safe. Someone could very easily end up hurt by taking these medications unmonitored, so you shouldn't be willy nilly prescribing them without a legitimate order.

Speak up. You're right to be concerned here. Verify what needs to happen to make this process legal before you sign one more thing.

Edited by FacultyRN