What do you consider verbal orders? If you text paged a Dr to ask for a diet change, for example, could the secretary answering the phone take that 'OK' for the change?
This happened for me, and I said to the secretary that this was a verbal order, and she said it wasnt, since the Dr told her "just tell her it's ok", then the secretary was upset when I showed her (or tried to ) that I had to write this in the chart as an order.
Am I being too 'by the book'? Should I relax a little more?
Also, do you write every little ok you get back from Dr's as an order (such as ok to have echo tomorrow not today)?
I thought verbal orders were a no-no with Jcaho now anyway? We are only allowed to take 'Read back telephone orders'; no verbal orders allowed. It it different elsewhere?
in a ltc where i worked the doctor wrote a standing order that diets could be down sized in texture for 72 hours
you could change a diet from regular to pureed but not vice versa,,also could not change calorie or salt/sugar restricted . this would give you some lee way like on week end where the order could be rewritten on monday
otherwise no, a unit clerk should not take any order..i think most places have a desk nurse for this purpose so that the md would not have to wait for nurse to be hunted down and you would have a licensed person to take any orders..it was the desk nurse's responsibility to inform floor nurse of all changes/new orders, she also ordered lab, informed dietary, ordered x-rays, tests etc
That's entirely different than a simple verification of a diet order.
Sometimes, when we call during the day, we leave a message with the office nurse with our request. For instance, I'll call for a diet upgrade, leave a message, and get a call back with an answer, which is sometimes through the office nurse.
For a simple diet change request, I'll trust the unit secretary if I am truly indisposed. I will bend the rules at times, using my nursing judgement if it is as straightforward as a diet order. For certain labs at specific times, you need to check to see if they are entered correctly, whether it's a written or verbal order. But a simple diet order right before lunch, sometimes it's in the best interest of the patient to expediate their needs being met by trusting another member of the healthcare team.
which is a prime example of cutting corners where they should not be cut- just because it is expedient. this also does not address the point that it is not legal, and can be dangerous in a litigious society even if something seems small and insignificant at the time.
Listen to the voice of experience! I just was reprimanded by our state nursing board because of an order for 600 mg of Motrin. Although I had a letter from the P.A. defending me, they were not interested. If you take an order thru someone like the unit secretary, and try to defend yourself, they WILL NOT care or listen. Save yourself time,(2 years worth for me), money, mental anguish and a stain on your license. Take the 2 minutes and CALL THE PHYSICIAN YOURSELF!
plumrn, BSN, RN
424 Posts
I thought verbal orders were a no-no with Jcaho now anyway? We are only allowed to take 'Read back telephone orders'; no verbal orders allowed. It it different elsewhere?