Would you put your initials on verbal orders?

[Thundercat]

I am currently working at a LTC facility. The DON asked me to go through some of the orders that the doctor either written or ordered verbally to make sure they are correct in the Mar and to put my initial on the orders; however, the problem I have with doing this is that most of the orders are verbal taken by other nurses, some who are no longer working in the facility. The DON keeps persisting for me to do them and not the other staff nurses. I have been off for one week, and when I spoke to her on the phone, she asked if I had went through any of the orders. I believe that she knows the other nurses will not do them, and she doesn't want her initials on the orders as well. The facility is considered one of the worst facilites within the state. Please help! Would any of you guys put your initials on a verbal order that you did not hear?

[XB9S, BSN, MSN, EdD, RN, APN]

Thundercat the fact that you are asking the question makes me think that you already know the answer. If you haven't taken the order yourself how can you verify it is accurate and without being able to do that you shouldn't be signing it.

I wouldn't sign or initial anything that I hadn't actually done / heard / witnessed myself it's not safe practice

[Flare, ASN, BSN]

I would not initial anything that i did not hear with my own two ears.

[CoffeeRTC, BSN, RN]

I'm confused. Did they get taken off by a nurse when they were received?

Every month we do a change over check and will intial the new MAR, TAR and Reorder sheet next to the med or order that we checked. Your intial means you checked it against the orders and it is correct for that month. We make corrections as needed by getting orders from the doc. Sometimes orders that were d/c'd or expired were not sent to the pharm so the new sheets are wrong.

is this kinda what you mean? Do you have a monthly check p and P in place?

I wouldn't intial an order long after the fact and one that I didn't get. It sounds like the DON is trying to do a chart review...Again...I'm confused because every place I've worked have done this at least monthly. Most places have 11-7 review charts to make sure no new orders were missed from that day.

[Thundercat]

No this is not the check that one would do at the end of the month by the MN nurses. The DON asked me to do this last week and I was not checking new MARs. I am confused as well. I do not know why she wanted me to initial orders that were on the MAR from the beginning of Feb. If the DON was in fact trying to do a chart review, should she be the one to do this instead of me. She only asked me to do this not the other nurses. I don't get it.

[classicdame, MSN, EdD]

Sounds like the DON is trying to get all the charts to appear correct when they are not. The real energy should be placed in drilling down to who was on shift that day and took the order and did not document appropriately. If she wants to initial it, let her do it. Keeping your license is more important that keeping your job.

[Thundercat]

Although I might know the answer, the reason why I am asking is because I wanted to know other people’s opinion. I am not fully understanding the reason why the DON wants me to do this. I have never worked in a place where I had to go back and put my initials on a verbal order given bythe doctor when I did not take the order.

[Whispera, MSN, RN]

Ask her why she wants you to do this and tell her your concerns. I would never initial something I hadn't written.

[XB9S, BSN, MSN, EdD, RN, APN]

I agree with Whispera, it would be worth asking her and discussing your concerns with her that way she can explain how she feels this is acceptable practice and you can be comfortable in what your being asked to do.

[systoly]

Maybe I'm not picturing the situation correctly, but my first thought goes to the almighty fax machine. Couldn't you fax the orders in question to the doctor's office and get the doc's signature on it?

[chenoaspirit, ASN, RN]

I would never sign anything I didnt witness or do myself. If anything ever happens, it will be you in court because it will be your name attached to it. I would explain to her that you dont feel comfortable doing this because you were not the one who took the orders. I agree that she needs to be correcting the person who took the orders and didnt sign their name when taking it. If she doesnt, then this will only continue to happen and she will be asking you again in the future to do the same thing. No way would I sign anything like that, nope.

[Mr Ian]

Not a chance; no way. Ever.

And if she insists - ask for it in writing.

If she threatens - ask her for her license number for the BON.

If she cries - give her a tissue.

Then tell her to put her own name to it.