Verbal Orders

[paddler]

I was calling a PT/INR result to the ordering MD office and the nurse had the gall to ask me to fax the result to their office. I explained nicely, that I was presently sitting in the patient's home and did not have access to a fax machine, and would not until later the next day and would you please just pass the result to the doctor for advisement. She then asked me to call my office and tell the secretary (ya right we have someone sitting around waiting to receive this information and have nothing better to do), and she could fax it to them. I said, "Um, I guess I could do that, but I am in the patient's home now and kind of need to tell her what Coumadin dose to take and when to recheck her INR." Only then did she agree to give verbal report to the doctor. WHAT IS UP WITH THAT? (And no, she is not a new nurse).

[berube]

i think it is best to just fax it to them, they they have a hard copy for their records...now if the results are critical that is different.

we do call our pt/inr's to the manager and she faxes it to the md, md will usually fax it back with new orders...but like i said if it is critical i would make sure you talk to a nurse and then follow up with the fax

[morte, LPN, LVN]

liability....you verbally say 3.4 and it actually is 4.3 different situaton, different orders. What you need is to have the LAB fax the info to the doc.

[cathrn64]

I use a Pt/INR machine. There are MD offices that require us to fax the results to them. Our office created a a form for this. The Dr's usually fax us back with orders. They expect us to fax them unless the results are critical, than we can call.

[caliotter3]

As much as anything else, she might have been messing with you, pushing your buttons. She knows what you can and can't do.

[caliotter3]

Morte has it. Next time have the lab do it. The lab should have done that to begin with.

[twokidsmom,rn]

We do fingerstick INR's. Get a result call MD and they usually tell me right then and there. THen I write a VO when I get back to the office sometimes it is the next day for them to sign.

[annaedRN, RN]

We do Coagucheks too. Much nicer for everyone. We call the MD office - sometimes get an order for Coumadin +/or next PT/INR. Then we call our office supervisor with results who uses a form to fax a follow-up "hard copy" result to the doc. That way its taken care of on all angles - so far, no problems. Been doing them about 2 yrs now

[carwin]

Yes have the lab fax to the doctor but you still call to make sure they receive the results and get your orders. if you draw a lab, you are responsible for obtaining and reporting the results to the ordering clinician. Then, CHART it. I always say call the lab yourself because labs drop specimens, they don't pick up specimens and you won't know until you call them. I will leave that nation-wide lab un-named.

[Isabelle49]

We do coags too, call our office and they fax md then get back to patient on coumadin dosing.

[systoly]

How did you get the results? Anyway, ask the office nurse to contact the lab (eventually she might) or ask the lab to fax to the Dr office. Usually I know the target range the doc is shooting for and if the lab result is below it I'd give the coumadin, if above I'd hold, if it was critical the doc would have been notified by lab.

[tewdles, RN]

Many of us obtain INR results INDEPENDENTLY of a laboratory. There is no lab to fax the results...the bedside nurse is the lab with her little red machine. As said before, we get the result from the machine, call it to the doc and get orders, call it to the office and the office creates a "lab report" which they fax to the MD office for their records and to obtain signed orders.

If the MD office refuses to receive your verbal report of the results and to give you orders they may delay care.