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Discussion

Telephone order?

I need some advice for future reference. I have been working in LTC and Rehab for almost two months. I am a new LPN and this is my first job as a nurse. We had a new admit the other day, of course no meds or script came with the patient. He gets narcs pain meds and ativan at the hospital. I called the facility dr that was assigned, he would not give narcs ordered till he sees the pt , I called Dr Who (medical director) and he said the same thing, but agreed to call in Ativan. So he asked me to leave info in his voicemail so he can cll in pharm, which I did. Family members would not leave me and my supervisor alone.. So i continued my medpass while my supervisor deals with the family. Few hours later, my supervisor came to me with a fax from the pharm thats giving us permission to get the ativan from our med room for one time dose only. I gave it to the patient, on the end of my shift as I was writing the order i realized it was not the doctor i left the message with called in the pharmacy it was another dr! So i realized my supervisor had changed the pt's dr from Dr Who to Dr Sue...

Dr Sue called the phrmacy for morphine and ativan and i wasnt informed about the change of doctors. I did not write the telephone order bcoz i am not the one who talked to him it was my supervisor. Next day a different supervisor told me that i needed to write the order bcoz i am the one that talked to the doctor and i am the one that gave the Ativan. But its not Dr Who that called it in and I did not speak to hime it ws my supervisor!!!!

Now i am confused. I was told at the nursing school you never write an order if you didnt take it. My coworkers said its not a big deal its only one time dose and i have to write the telephone order as coming from Dr Sue since he is the one that called the pharmacy. Is it right??

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    You are correct. You never write an order you did not hear from the doctor. Whom ever spoke with the doctor for the morphine order should be the one writing that order.

    You only write what you are told by the doctor and you did that. The supervior should know better, much better than to ask or tell you to do that.

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    To piggy back off of the OP, i am afraid of the phone order situation! What if the doc is asleep in the middle of the night. Say something goes wrong with the patient with the order and i wrote it down as per the call. What happens if the doc comes back and says he didnt give the order or, i wrote down the wrong dose? Im starting nursing school this fall and while i doubt this happens often, it still freaks me out!

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    I was left with no choice I had to write the order. It was Friday and that supervisor is off on the weekends and the state came in yest. It did not seem like a big problem cause the pharmacy faxed the order i just needed to write it out in the order form so when the Dr comes in he can sign it. I am crossing my finger it will not cause me trouble in the future for doing it. Being a new nurse I dont know exactly whats the right thing to do..

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    I was left with no choice I had to write the order. It was Friday and that supervisor is off on the weekends and the state came in yest. It did not seem like a big problem cause the pharmacy faxed the order i just needed to write it out in the order form so when the Dr comes in he can sign it. I am crossing my finger it will not cause me trouble in the future for doing it. Being a new nurse I dont know exactly whats the right thing to do..

    You always have a choice. Don't let anyone bully you into doing something that you are unsure of or know not to do. Is your place of employment unsupervised on the weekends? There has to be someone up the chain to contact. I would have called the supervisor at home if I had to before writing an order I did not take (especially for a narcotic). You have to stand up for yourself in situations like this. If anything would ever come of it, "he/she told me to do it" is not an acceptable answer. Good luck to you :)

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