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What have you done without a Dr. order???

Nurses   (21,226 Views 69 Comments)
by PureLifeRN PureLifeRN (Member)

PureLifeRN has 4 years experience and specializes in OR.

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You are reading page 2 of What have you done without a Dr. order???. If you want to start from the beginning Go to First Page.

MassED has 15 years experience as a BSN and specializes in ER.

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Sorry I didnt know I was committing such a big crime with this post! Sheesh! I would do the blood/stool/urine samples if I knew the doctor and they hadn't made their rounds yet. Never had a complaint so far!

you are not. Depends on where you work as to how you answer this question too. Don't let people jump all over you. It's a great post, I think.

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blondy2061h has 15 years experience as a MSN, RN and specializes in Oncology.

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I gave meds twice without an order in situations where the MD was just not calling me back and I was genuinely worried about what would happen with my pt if they didn't get the med. Both times I got the medication ordered shortly after. Once was IV benadryl to a patient who was having a bad platelet reaction and clearly beginning to lose their airway (hives coulda waited). I can't recall the other time.

Both times occurred before my hospital had a rapid response team.

We have standing orders for c-diffs.

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nursel56 has 25+ years experience and specializes in peds//ambulatory care/HH-private duty.

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Saving a specimen that might be harder to get later on for a test you know will be ordered based on taking care of hundreds of people and working with Doctor X and knowing his/her habits doesn't seem like it would be risking a license to me, but honestly I look forward to seeing the spectrum of opinions on this.

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dthfytr has 30 years experience as a ADN, LPN, RN, EMT-B, EMT-I and specializes in ER, Trauma.

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Oh no, I'm just a humble country nurse, not a starship captain. I couldn't even take a potty break without a Dr's order. If I accidentally saved patients lives, saved doctors asterisks, or saved patients from doctors, do you really think I'd enumerate it here? Just call me Mr Ed, because I'm a lot smarter than I look.

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I'm probably too new of a nurse to answer this question because I've never been put in this type of situation, but I know I wouldn't hesitate when it comes to placing a patient in respiratory distress on oxygen. I also don't see the harm in collecting a urine or stool sample without an order, but I'd wait for the order before I send it to the lab.

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all_over_again has 5 years experience.

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I have given IV dextrose to a diabetic in an emergency. Immediately after, I called the doctor to get an order. The patient lived. I would have preferred to lose my job than allow someone to die unnecessarily.

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PureLifeRN has 4 years experience and specializes in OR.

5,945 Visitors; 149 Posts

I had a patient once that had about 5-6 BM's during the shift. I decided to be prudent and call the GI doc and ask for a c-diff order, and his response was "hmmm, well what did the BM smell like?? If it smells bad, then order a c-diff." honestly, I never called him again for a c-diff order.

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RNperdiem has 14 years experience.

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What kind of setting do you work in?

I could see this being an issue if you work somewhere where the doctors are slow to respond.

I work day shift in a teaching hospital, so getting at least a verbal or phone order is easy.

The fact that you are writing about this issue suggests you are not fully comfortable with this practice?

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StNeotser has 10 years experience as a ASN, RN.

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giving o2 to a patient who desatted ..is part of our job, isnt it?

Of course it is! However, in theory, one must request an MD order before doing so. Deep breath, deep breath.........

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2 Followers; 103,143 Visitors; 14,620 Posts

Of course it is! However, in theory, one must request an MD order before doing so. Deep breath, deep breath.........

This is why it's important to know your facility's P&Ps. I've never worked anywhere that there wasn't a written policy that RNs could initiate O2 at up to 2 lpm as a nursing action (without a physician's order) in a situation like that, and then let the physician know about the situation.

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2 Followers; 103,143 Visitors; 14,620 Posts

well first of all, we should be anonymous on here, and any other internet site, if you're concerned about privacy.

Anonymity goes both ways on a site like this. None of us ever know, when we post here, who is reading our posts and whether we may have inadvertently disclosed enough information at some point to enable someone who knows us to identify who we are ...

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imintrouble has 16 years experience and specializes in LTC Rehab Med/Surg.

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giving o2 to a patient who desatted ..is part of our job, isnt it?

02 is the only thing I'll apply/give without an order. I can't defend my license against ordering tests, giving meds without an order.

If I do apply 02, I'm on the phone ASAP getting an order for that 02.

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