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

Nurses   (21,213 Views 69 Comments)
by PureLifeRN PureLifeRN (Member)

PureLifeRN has 4 years experience and specializes in OR.

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Somehow the human race survived a long time without doctors orders, so they just might not be the hallowed message from the Gods we're told.

I don't think anyone here has suggested that physician orders are "hallowed messages from the Gods," and I've never heard that suggested anywhere else, either. But they are legal requirements. Like driver's licenses -- I'm sure that you, and everyone else here, are just as competent as I am to drive a car safely -- but, if we do it without a valid driver's license, we're breaking the law and there will be legal consequences if we get caught. Not a chance I'm interested in taking.

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What is it that we think is going to happen exactly by discussing this?

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nurse2033 is a MSN, RN and specializes in ER, ICU.

3 Articles; 28,197 Visitors; 2,122 Posts

I just stick to protocol. Need my license.

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

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You're naive if you don't think things like this can somehow be traced back. NOTHING is anonymous on the internet.

true, which is why one wouldn't want to post any incriminating information.

But really, I can't imagine there's any sleuth out there dead set on finding a nurse who posts that they put O2 on a respiratory distress patient without an order. Or similar lesser deeds that blur the line between physician order and nursing autonomy.

haaa!!!!

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

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Ultimately, when you come right down to it, you can always defend doing what's best for the patient. Working in ER's, for example; I'd much rather face a jury for giving a minor good medical care without parental consent, than face a jury for letting a minor suffer or deteriorate for lack of parental consent. I might lose my job, my license, the $67 I have in the bank, but I wouldn't lose 1 minute of sleep. Somehow the human race survived a long time without doctors orders, so they just might not be the hallowed message from the Gods we're told.

amen to that.

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

1 Article; 20,158 Visitors; 2,636 Posts

I don't think anyone here has suggested that physician orders are "hallowed messages from the Gods," and I've never heard that suggested anywhere else, either. But they are legal requirements. Like driver's licenses -- I'm sure that you, and everyone else here, are just as competent as I am to drive a car safely -- but, if we do it without a valid driver's license, we're breaking the law and there will be legal consequences if we get caught. Not a chance I'm interested in taking.

dthfytr was being a bit tongue in cheek. Truth veiled with heavy sarcasm. I think how you respond to the OP depends on where you work also.

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Scarlette Wings has 27 years experience and specializes in M/S, ICU, ICP.

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as i said on another thread, i am the "oxpecker" on the rhinoceros's back sounding the alarm. it just doesn't get any easier than that.

oxpecker.rotflmao. loved that one. i just absolutely loved that!

:hpygrp:

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2 Followers; 103,132 Visitors; 14,620 Posts

dthfytr was being a bit tongue in cheek. Truth veiled with heavy sarcasm.

I am well aware of that. However, being sarcastic and glib doesn't change the (legal) reality of the situation. I have seen many nurses get into trouble over the years because they didn't take scope of practice seriously, or believed that the "rules" weren't to be taken seriously or didn't apply to them.

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when I was a new grad a resident gave me a verbal order for pain meds for a patient. He had the chart so I assumed he would write it. Well he didnt and I took the med out on override so it looked like I took out a narc with no orders to back it. I didnt see him after that morning to get the order and he wasnt a regular. I didnt even know his name. That was scary. On my most recent unit it was common practice to get stat cxr and abgs for pts in distress....ekgs for CP. And every time the docs would ask if I had done those things when I finally got around to calling them. They almost expected it and got kinda ***** if you called them with nothing to report to them, maybe because it was the middle of the night...IDK. I will admit that I am not perfect and I have done these things but some of you are not being honest. What about when a doc orders 25mg of phenergan but you thought the old lady only needed 12.5mg and thats what you gave. Or what about not giving certain meds at all and just not saying anything or calling the doc. I have seen IVFs that were turned off without a docs order and then just tell the doc on rounds why you cut it off. I think there are a lot of things we do without orders but you just dont think about it.

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Not only do I think it depends on where you work facility wise, but I also think you will, in general, get different opinions from those who work in the ED vs. those on the floor.

That's all I'm gonna say... ;)

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813 Visitors; 6 Posts

If I need an order to do it, I'm getting the order before I do it. I spent too much time studying & worrying about exams to lose it. If I ever work somewhere where docs are slow or don't respond in a timely manner, I'd get my behind out of there ASAP. New grad speaking

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CoffeeRTC has 25 years experience.

21,410 Visitors; 3,725 Posts

In LTC (at least my state) there are no standing orders. None. If someone is in rep distress you need an order for O2. Sooooo this is a holiday or late shift and you are trying to get ahold of a doc. You've called the service and left a message requesting a call back stat, you've tried his cell phone. Now what? You call the medical director...quess what...same problem.

What do you do? 2L of O2 might help.

What about that stool specimin or obvious UTI? Get the sample and then get the order? Or wait for ever and get the order in the am when the office is open?

We all know what the right answer is to the OPs question and yes.

CYA and know your docs.

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