Was this such an unreasonable request?

[verene, MSN]

Yesterday at work I had a call from an RN from another clinic call to say that MD wanted to make changes to one of our resident's insulin dose. Perfectly fine. I asked her to fax me a written copy of the order (per our facility policy we MUST have a written order for all med changes) and she pretty much told me off and asked why I couldn't take a verbal order. I told her it was facility policy, and for liability reasons we have to have a written copy. She again refused to fax the order and said when she changed the Rx with the pharmacy she'd make them clarify the information for us.

She made it sound like we were a substandard facility for not taking a verbal order, and that I was asking for way too much work on her end. Is it really that weird to ask for a written order for med changes? I thought it was pretty standard and don't understand why I got chewed out.

[Rose_Queen, BSN, MSN, RN]

Absolutely not unreasonable. Verbal orders should be restricted to emergency situations and situations when the physician truly cannot write an order, such as when scrubbed in for surgery (I know, likely doesn't really apply to your situation). Telephone orders should only be taken directly from the physician- without that, how do you know the order actually came from them? Even in the OR, I will hold the receiver up so the nurse that paged can hear the surgeon, then confirm that they heard correctly. It's never nurse to nurse for orders.

[firstinfamily, RN]

How do you even know the person on the other end is a nurse??? I have had secretaries give verbal orders for a MD. You did the right thing, apparently she just did not want to hear it. I would never take a verbal order for medication changes from anyone other than an MD. The rest can fax the order signed by the MD. It made more work for her, but too bad!!!

[NickiLaughs, ADN, BSN, RN]

She is the dingbat. Good for you for protecting your license. I think you did what any prudent nurse would do.

[verene, MSN]

Thanks everyone! I was thinking she was the one in the wrong, but I have limited experience, so it's good to know that I did everything right. Glad I stood my ground. :-)

And just to clarify... I'm a CNA, not a nurse.

[nurse4ever08]

You can take a verbal from MD not office nurse. Remind her of legal verbal orders.

[Rose_Queen, BSN, MSN, RN]

And just to clarify... I'm a CNA, not a nurse.

Does your scope of practice/policy allow you to take telephone orders? Where I work, only RNs can take telephone/verbal orders.

[verene, MSN]

No... I can answer the phone but I can NOT take verbal orders. Another reason why I needed the order faxed.

[blondy2061h, MSN, RN]

The fact that she wouldn't fax it makes me suspicious that something fishy may have been up. That's crazy.

[mluvsgnc]

I work in PDN and often have to call the doctor's office to take a verbal telephone order from another RN (who communicates with the doc). It is read back, initialed, timed, and the name of the particular doc is written in on the 3 layer carbon copy (one for the plan of care, one for client, and one for agency), as is who the RN that it was read back to. My agency faxes those orders over to the docs, who signs and returns them. We cannot accept orders over the phone from LPNs or administrative personnel. A couple differences, I guess, is that clinics and PDN are two different animals, and with PDN, it is usually us (the RNs) calling them (the doc's office) b/c parents have indicated that an order was or needs to be changed.

I think you were right in requesting it faxed. I think if an RN called my pt.'s home and said so-and-so needs to be changed, I would want a signed order from the doc, else I wouldn't implement it.

[Here.I.Stand, BSN, RN]

Even if you were an RN, you can't take TO/VOs from another RN--they have to be from a provider.

[RedInScrubs, ASN, RN]

Absolutely not unreasonable. Verbal orders should be restricted to emergency situations and situations when the physician truly cannot write an order, such as when scrubbed in for surgery (I know, likely doesn't really apply to your situation). Telephone orders should only be taken directly from the physician- without that, how do you know the order actually came from them? Even in the OR, I will hold the receiver up so the nurse that paged can hear the surgeon, then confirm that they heard correctly. It's never nurse to nurse for orders.

Totally agree. I would not feel comfortable writing a telephone or verbal order unless I was talking directly to the doctor and could verify it with the source. I would never take a verbal from another nurse without a written copy from the physician, because I cannot completely verify that the order actually exists. If I'm writing an order under my professional license, I need proof that is exists, and I don't think asking for a faxed copy is unreasonable at all.