Verbal Orders - MD to RN to RN without Chart

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Specializes in Acute Care Psych, DNP Student.

MD gives a verbal order to an RN. That RN (#1) does not have the chart to note the verbal order. Another specialist has the chart. RN #1 gets busy and asks RN #2 to carry out the verbal order #1 received. Is this OK? I (RN #2) felt very strangely about this today. It seemed out of the chain of how things should be.

Granted, the order was only for 1 liter NS @ 500 ml/hour, but still?

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totally dangerous.not a good habit to get into. starts with normal saline, but once in the habit you could find yourself in big trouble if something more serious is ordered and done in that manner....we all know if there is a bad outcome who would get the blame and the doctor can always deny giving the order at all. answer....get the chart and place it infront of the doctor.

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Specializes in Acute Care Psych, DNP Student.

The specialist had walked off the unit (but not off the property) with the chart. He does whatever he wants and the facility does.not.care. RN #1 is by boss, too. I told him I did not feel comfortable with the scenario in the OP.

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Specializes in Give me a new assignment each time:).

Do not do that! If I were you, I'd offer to help RN #1 with whatever he/she is busy doing so that he/she can carry out the order that he/she recieved verbally. I had a similar experience with med over the phone. Example there is a big difference between 1.5ml and 5.1ml. You get the idea. But nurses are responsible for following the MDs order. One MD played back a recording of his telephone order to me. Thats tells me that we all have to take responsibility for our actions and defend our actions. I hope it helps. Practise safe :)

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Specializes in OB.

Suggestion for the next time: If using written physician's order sheets have nurse #1 take a new order sheet, stamp it with the pt's stamp or write in pt's name and number, write and sign the verbal order. Then when chart is returned the order sheet can be placed in the chart.

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Specializes in Geriatrics, Home Health.

If I was in RN #1's place I would have grabbed a blank "telephone order" sheet, written the patient's name at the top, and given it to the MD.

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Specializes in rehab.

I wouldn't feel safe doing that. Instead I say just grab a brand new physican order sheet (stamp or write the pt info- at least name) and just use that and put it in the chart when the chart reappears.

I'd say of it happens again, offer to do something with the other patients for the nurse so that she can run and take care of the verbal order that she was given. Or even just hand the blank sheet to her and ask her to write it down quickly so you can follow a written order.

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Specializes in Acute Care Psych, DNP Student.
If I was in RN #1's place I would have grabbed a blank "telephone order" sheet, written the patient's name at the top, and given it to the MD.

The MD wasn't there.

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The MD wasn't there.

She said RN#1. the RN the doctor gave the order too...

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Specializes in Acute Care Psych, DNP Student.
She said RN#1. the RN the doctor gave the order too...

Yes. I read that too quickly.

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Depends entirely on the doc and the RN#1. I have carried out an order I didn't actually hear, but never one that I didn't totally understand and feel was warranted, and later verify it and sign my name to it.

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RN taking order gets blank order sheet. Stamps with patient order info. Transcribes order. Performs readback. Carries out order. I HATE carrying out verbals that someone else has taken. If RN #1 couldn't carry out order, RN #1 should have asked RN #2 to come to the phone to take the verbal order. (This is in my perfect world. YMMV.)

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