Wow. Just wow

BrandonLPN, LPN · Mar 5, 2015

If you know it and you don't report it......with at least a simple incident report,
you are complicit in the deception.
The incident report is your 'stay out of jail' card.
Nurses, stop being stupid!!
Stop covering for your 'friends' errors.
Your priority is the patient..that's why we have a medication protocol in place.
Stay out of trouble...follow it.
Your license depends on it!

If your priority was really the patient, you would not make them suffer while waiting for the order to go through the whole song and dance.

Are you even a nurse? You come across as though you have zero real-world experience.

dinah77, ADN · Mar 5, 2015

Cayenneo6
You are admitting to an illegal act on a public site!
You admit to deliberately and knowingly acting outside the scope of your license!
You are prescribing/giving medication without an order......that's a criminal/illegal offense.
What you think and 'feel' and your 'rationale' won't help you if
you find yourself in court, should your patient have an adverse reaction.
Sorry, that is not only stupid...it's arrogant....and shows your gross lack of experience!
I am trying to warn you to help you....your license is in dire jeopardy.
Go back to what you were taught.
The day someone, friend, foe, or stranger, reports your illegal activity, you'll wish you had!
You won't be the first or the last to wish they'd followed protocol,
when someone who does follow protocol, is appalled at your deception,
and reports your deliberately illegal activity.

Wow. Just wow with the drama

I think you should add some more exclamation points

klgteamnurses · Mar 5, 2015

It sounds like something is missing from the story. I would hope that it was not deliberately done. That would go against the overall goal of a nurse! A proper investigation would need to be done.

VANurse2010 · Mar 5, 2015

If you know it and you don't report it......with at least a simple incident report,
you are complicit in the deception.
The incident report is your 'stay out of jail' card.
Nurses, stop being stupid!!
Stop covering for your 'friends' errors.
Your priority is the patient..that's why we have a medication protocol in place.
Stay out of trouble...follow it.
Your license depends on it!

If what you're staying were true in all circumstances, the override function in automatic dispensing cabinets wouldn't exist. Verbal orders are not always able to be written and sent to pharmacy before a mediation has to be given. You're very out of touch with reality if you think they can be or that it's appropriate in all circumstances.

mhusen5 · Mar 5, 2015

BrandonLPN

My PRIORITY is first and foremost the safety, comfort and well-being of my patient, not my inconvenience, yours, or the Mds.... by deciding to play "doctor wannabee" and prescribing/giving medication without an order! Don't you get it...it's illegal??

You are practicing medicine out of the scope of your license!

You are engaging in criminal activity!

Doesn't matter how many warm fuzzies, rationales about patients in pain,

or nasty critiques of me ...you care to toss out there!

It's the law. If you value your license, you'll stop playing doctor.

Those, with integrity, will resent it and report you when you least expect it!

I hope you are not one of those people, who choose to only respect and obey the laws they like or that are convenient for them?

Best you rethink, use your head, and stop your illegal activity...before it's too late.

I choose not assassinate your character, just comment on your criminal and illegal activity...have a nice day!

DeeAngel · Mar 5, 2015

I think you should pay attention to your own nursing practice and not worry about what others are doing when you do not know the facts for a certainty.

Red Kryptonite · Mar 5, 2015

Are you even a nurse? You come across as though you have zero real-world experience.

You called it.

Angeljho, MSN, NP · Mar 5, 2015

Newsboy...
It is a BIG deal. Why don't nurses get it??
It's ALL criminal activity! It does not matter what the medication is!
If you HAVE a verbal order...you document it and give the medication.
If you have a written order..you give the medication.
Otherwise you have no order!!
Therefore you are practicing medicine outside the scope of YOUR license, period.
You are on a very slippery slope, legally, justifying the fact that you gave any
medication for which you did NOT have an order..regardless of how you want to rationalize that it was ONLY a motrin or an aspirin!!
The FACT is you gave a medication YOU ordered...not an MD!
The character of many of the doctors and nurses leave a lot to be desired..cover up, cover up, cover up! What happened to ethics??
Trust me, when you find yourself in court should the patient have an adverse reaction, and it does happen with OTC medications, you will be guilty of not only a medication error but also deception.
No patient, family, court or Nursing Board will ever tolerate/condone the deception.
Your license is toast!
Mistakes unfortunately happen. Deception is a deliberate act!
Those of you, who give any medication without an order will be thrown under the bus by the " buddy" MD, you didn't want to "bother"! He'll protect his license..not yours!

What kind of black and white world of nursing do you live in? Posters have listed plenty of instances where it is not practical to wait an hour or more to get a doctor's order and then give a med - as long as it is safe. Again, it is not black and white. I'm guessing you are a brand new nurse. You're following textbook nursing and that is okay. But in the real world, nursing is anything but textbook. You will soon come across a situation where you must practice in the real world.

Angeljho, MSN, NP · Mar 5, 2015

@Red Kyrptonite, thanks. It all makes sense now.

michlynn, BSN, RN · Mar 5, 2015

It really depends on the situation and the drug. I think your inexperience is showing here.
P.S. What you're saying about prescription vs. non-prescription is non-sensical when applied to the hospital, since everything requires an order in acute care. Tylenol isn't always innocuous, either.

During my last few years of "inexperience" I've been taught by my SENIOR staff what is appropriate and what isn't. If a doctor gives me a verbal order then yes I will go get the medication before putting the order in the computer if a patient is in distress but I would never take it upon myself to order something for the patient and then inform the doctor later. Again, it doesn't matter what kind of relationships you have with the doctor, I would love to hear you defend that in court if something happened to the patient based off of you taking it upon yourself to play doctor.

roser13, ASN, RN · Mar 5, 2015

@Red Kyrptonite, thanks. It all makes sense now.

It sure does. Hell hath no fury (or righteous indigation) like a pre-nursing student.

macawake, MSN · Mar 5, 2015

And frequently, I will implement a verbal order before transcribing it, faxing it to pharmacy, getting it verified and entered in the eMAR. No WAY am I going to let my post op patient suffer while I wait for that verbal oxycodone order to go through the proper channels.

I do too. You're a nurse after my own heart. There's no way that I'd let a patient suffer needlessly while I'm busy with administrative rigmarole. The verbal order is valid once I received it, in my opinion the formality of crossing t's and dotting i's can be done after the patient gets relief from the pain or PONV or whatever it is that ails them.

We have good standing orders on my unit though, so this rarely comes up. If I need a medication for a patient at 2 am and it is not on the standing orders, it usually means there's something going on that the provider needs to know about- and I do consider uncontrolled pain to be worthy of a call, even if I know it is within the range of normal for my post op c/s patient.

Same here. Every unit I've worked on have had standing orders as long as my arm. For example for treating PONV I had at least three different medications to choose from when I worked med-surg. The physicians expect me to be able to read a drug guide and know I wouldn't for example choose Ondansetron for my patient with LQTS and that I wouldn't choose Metoclopramide for my Parkinson's patient or for my patient with a suspected bowel obstruction.

I wasn't actually prescribing since it was standing orders but some critical thinking is required since I have several drugs to choose between and the patients status, medical history, allergies and interactions with other medications have to be taken into account.

I have a good working relationship with my physicians and I know that they support me as long as I don't make reckless decisions. If I'm the least bit uncertain about a medication or the patient's status I will contact them before doing anything and they know it.