V.O.R.B

[HeartsOpenWide, RN]

What do you do when you get a verbal order from a doctor? What if the doctor is in the room and orders the med STAT?I.E. the doctor asks you to give I.M. Pitocin after the baby is born when a woman wripped out her I.V. (baby on perimeium)... obviously you are not going to say "hang on, can you write an order for that?" your just going to give it ...and get the order later right? How do you write this order up? I have been told we are trying avoid V.O.R.B.s How do you write the order later? Do you ask the doctor to write you an order or write a V.O.R.B. after the fact and have them sign it? Does it have to be worded differently because you are getting the written/charted order after the fact?

[highlandlass1592, BSN, RN]

Yes, you do need to try to avoid most verbal orders, JCAHO has recommended that for years as do many BON's. However, especially in emergent situations, they are usually allowed. In my case, I'll carry out the order, then later write in in the chart using my facilities guidelines then the MD will sign it. Your facility must have a policy for how and when nurses should accept verbal orders and I'd encourage you to find that out. If you go around hospital policy, that is where you place your license on the line. You should also become familiar with your BON's position as well as they are the ones credentialing you. It's not that difficult to deal with. You will run into some MD's who try to give verbal orders all the time, you may need to set limits with them. I have refused non-emergent verbal orders from MD's who have a history of not signing those verbal orders or stating they never gave that order.....I'm not risking my license for them to play games.

[PostOpPrincess, BSN, RN]

Say,

"Doc, please write that order--thank you!"

And go get the stuff done.

If he didn't write it, do a verbal and he will need to sign it.

In emergent situations, all other things such as these tend to go on the wayside.

It is an understood "thing".

[NurseNora, BSN, RN]

In a delivery, there's no way he's going to break scrub and write the order for you. Many situations in OB can be considered "Emergent" and a verbal order is is acceptable. No doc is going to give you a problem over an order for IM Pit in a delivery in those circumstances.

My hospital has standing orders for IM Pit if no IV, or 20U in 1000cc LR, or to open the 30U in 500cc LR that was used for the induction. It's hard enough getting them to put check marks next to the boxes on the standing orders and sign them; expecting them to write verbal orders they've given? Ha!