verbal order not carried out

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I am so nervous at this moment..i dont know what to do..

I work in med surg going in my 2nd year now..but still learning a lot. Today is my day off and I just received a call from our charge nurse...asking me if I received a telephone order from a certain doctor and forgot to write it down...Indeed I did!!!

To make the story short, this doctor called and asked to put back the foley cath of his pt (which he ordered to be d'cd earlier, but then the pt could not void and started hurting so I paged him for that.) He also ordered to consult another doctor. I did insert the foley and the pt was relieved...but i failed to write those orders down.

So he did his rounds this morning and according to my charge nurse he was very angry and asked for an incident report to be written about this. He also wrote down in the progress notes that "nurse did not write the consult." My nurse manager asked our charge to call me about this.

Now what am I supposed to do. ..I am scared. I feel like I cannot go to work again and face everybody, more so this doctor. I understand it is my mistake...

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Calm down, you know we are all human, we make mistakes and we do forget,

own up to this mistake, make a plan of action to prevent further incidents, and go forward with your nursing practice. You did insert foley, you forgot a consult, at most the patient may have been delayed in seeing another doctor for a few hours, that is the best case senerio. Look at this as a valuable lesson, have a pen in hand with scrap paper and jot down orders when speaking on phone with doctor, then take the time after the conversation, and I do mean immediately after, to write the orders. The only time I vary from this is when Chest Pain is involved. Talk with charge nurse and manager, they will give you some tips also. If we nurses were not human and never made mistakes, we could not do the human side of the care we do. I will pray that you receive a blessing the day you return to work.

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Specializes in LTC, assisted living, med-surg, psych.

Don't be so hard on yourself........that's one mistake you will probably never make again! You will, however, make others, and that's what makes us all human and not God. :p

We all have to take a few a**bites in the process of 'growing up', as nurses and as human beings. The trick is to accept responsibility for the error, learn from it, and put it into perspective---e.g., what actual harm came to the patient from this error? Anything that doesn't cause physical or emotional damage, lead to a longer (and more expensive) hospital stay, or God forbid kill the patient, will usually be 'forgiven' readily by both doctors and management.......now you need to forgive yourself and move on.

You are still very new to this profession. No one, and I mean NO ONE, has it all wired, in two years or in twenty, and any nurse who thinks she does ought to quit. Be gentle with yourself......and get back to work!! We don't have a single nurse to waste. :)

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Specializes in Inpatient Acute Rehab.

Every nurse that has been a nurse for awhile has had something like this happen to them. Relax, it happens. The patient was not harmed.

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Specializes in Med-Surg.

I can't add much to the kind words above. When you get back to work speak to your manager and charge nurse. I'm sure everyone has moved on the more important issues. Lesson learned.

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Specializes in Me Surge.
I am so nervous at this moment..i dont know what to do..

I work in med surg going in my 2nd year now..but still learning a lot. Today is my day off and I just received a call from our charge nurse...asking me if I received a telephone order from a certain doctor and forgot to write it down...Indeed I did!!!

To make the story short, this doctor called and asked to put back the foley cath of his pt (which he ordered to be d'cd earlier, but then the pt could not void and started hurting so I paged him for that.) He also ordered to consult another doctor. I did insert the foley and the pt was relieved...but i failed to write those orders down.

So he did his rounds this morning and according to my charge nurse he was very angry and asked for an incident report to be written about this. He also wrote down in the progress notes that "nurse did not write the consult." My nurse manager asked our charge to call me about this.

Now what am I supposed to do. ..I am scared. I feel like I cannot go to work again and face everybody, more so this doctor. I understand it is my mistake...

worse things have happened. You did insert the foley, the patient was cared for. The fact that the consult order was not written was discovered promptly. So really no harm done. I guess it is an error since the order wasn't written but why did the doctor insist on a write up. On for goodness sakes why on earth did he write "nurse did not write consult" IN THE CHART?!!!!

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Specializes in Utilization Management.
We don't have a single nurse to waste. :)
Marla, I love that!

Listen to her, OK? I've caught worse mistakes.

If I'm real honest, I've made worse mistakes. The point is that you're owning up to it and it got fixed asap.

Nursing is all about fixing problems as they're discovered.

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Specializes in OB, M/S, HH, Medical Imaging RN.

I think this doctor is making too much of it. We all make mistakes, both nurses and doctors. I doubt anything will ever come of it. I always keep a small scratch pad in my pocket and write down whatever I need to remember. It might be an order or it might be just a cup of coffee that a family member wanted. It helps me alot. I might not write the order down for hours but least I don't forget to do it. This might help you also.

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Specializes in Psych, Psych and more Psych.

What do folks think about reading back orders (I think it has to do with JCAHCO's patient safety goals) as opposed to repeating back orders? I know nurses who write verbal orders with the comment that the the order was repeated back, but I haven't seen any read backs. Do you think it will improve accuracy of orders?

Mary

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I am so nervous at this moment..i dont know what to do..

I work in med surg going in my 2nd year now..but still learning a lot. Today is my day off and I just received a call from our charge nurse...asking me if I received a telephone order from a certain doctor and forgot to write it down...Indeed I did!!!

To make the story short, this doctor called and asked to put back the foley cath of his pt (which he ordered to be d'cd earlier, but then the pt could not void and started hurting so I paged him for that.) He also ordered to consult another doctor. I did insert the foley and the pt was relieved...but i failed to write those orders down.

So he did his rounds this morning and according to my charge nurse he was very angry and asked for an incident report to be written about this. He also wrote down in the progress notes that "nurse did not write the consult." My nurse manager asked our charge to call me about this.

Now what am I supposed to do. ..I am scared. I feel like I cannot go to work again and face everybody, more so this doctor. I understand it is my mistake...

Oh that "doctor" needs to get his panties straightened out. :angryfire

I could SEE maybe if you HADN'T REPLACED THE FOLEY - if it hadn't been DONE - WTF is the problem?

Okay, you forgot to write it down.

That's called making a late entry.

You replaced the Foley, the patient was taken care of.

His 14th mistress probably cheated on him so you have a target on your back.

:rolleyes:

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Why is the title of this thread "Verbal order not carried out?"

You carried out the order. You just didn't chart the order.

I did insert the foley and the pt was relieved...but i failed to write those orders down.

Yes we need to chart orders, but IMHO your CHARGE NURSE :angryfire should grow a spine and let this doctor have it in the chops.

Sorry, but the order WAS carried out, you're a good nurse and he needs to chill.

You need some support from the Charge Nurse to back you up. WTH is she calling you at home for? The foley was replaced....yes, you did forget to write the order, but there was no harm done and that could have been addressed when you went back to work.

Calling you at home because you failed to write an order down - but it was DONE?

Give me a break. :deadhorse

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Specializes in Oncology/Haemetology/HIV.
What do folks think about reading back orders (I think it has to do with JCAHCO's patient safety goals) as opposed to repeating back orders? I know nurses who write verbal orders with the comment that the the order was repeated back, but I haven't seen any read backs. Do you think it will improve accuracy of orders?

And someone addresses the magic name and issue safety.

As, I know it, verbal orders are suppose to not be given except in a case of emergency.

Yes, it is a problem to MDs to have to return to the facility to add orders. Yes, at 0100 AM, most of us will accept nonEmergency telephone orders.

But safety dictates that the MD write all orders that are not "emergencies". Sure, the foley needed to be put in...and it was, but could the consult have waited till the AM or would the patient's life be harmed...as most consultants would have waited til the AM to see the patient?

Why did the MD write DC foley, without a "may reinsert for excess retention/no void in 8 hours" on it? The sensible MD would have done so. Or he would have faxed a signed order to the floor to legally cover himself.

Sorry, but I am tired of nurses taking a bum rap due to the laziness of MDs and unwillingness to do their jobs as dictated by safety standards.

Sorry, that you had this error happen, but the MD is also a bit complicit in it.

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