Writing Telephone Orders/without calling doctor

[Nov2007_LPN]

Have any of you been asked by your DON and the doctor to write telephone orders for things like home health for wounds,Xrays for falls/injuries and UA's if you suspect a resident has a UTI without actually calling the doctor when these things occur and the doctor will sign the T.O when he makes rounds

No standing orders allowed at facility

[elizabells, BSN, RN]

Not in a million years. There are many, many threads on here by nurses who have done this and then been hung out to dry by the doc. Now, when it's 4am and I feel like a baby looks yellow and needs a bili level or something, I might draw it without waking up the oncall. But on a routine basis, during the day? You're just asking for a doc in a pissy mood to throw you under the bus.

[Nov2007_LPN]

This is in an ALf with an ECC/LNS license-And the Don keeps making statements to me that Im not writing up telephone orders for things that the doc has said we could but I dont feel comfortable doing it.I want the doctor to actually look at the wounds and make a decision.I feel like Im being asked to do his job.I asked if we could get standing orders the DON says its not allowed at the facility.

Is there some nurse practice act to back me up that I could make a written statement and refer to

[Nov2007_LPN]

This is in an ALf with an ECC/LNS license-And the Don keeps making statements to me that Im not writing up telephone orders for things that the doc has said we could but I dont feel comfortable doing it.I want the doctor to actually look at the wounds and make a decision.I feel like Im being asked to do his job.I asked if we could get standing orders the DON says its not allowed at the facility.

Is there some nurse practice act to back me up that I could make a written statement and refer to

[asoonernurse]

He doesn't even necessarily have to be in a pissy mood, either. He could throw you to the dogs with a smile on his face.

Michael

Not in a million years. There are many, many threads on here by nurses who have done this and then been hung out to dry by the doc. Now, when it's 4am and I feel like a baby looks yellow and needs a bili level or something, I might draw it without waking up the oncall. But on a routine basis, during the day? You're just asking for a doc in a pissy mood to throw you under the bus.

[Nov2007_LPN]

Okay so what do I do, im not going to write orders for the doctor but my DON keeps telling me too

[Okami_CCRN, BSN, RN]

If you do not feel comfortable writing it don't. It is not your DoN's license at risk but yours.

I know many nurses where I work that may order simple stuff like C.Diff and UA without calling the doctor but that is because

A: they know them for years/decade.

B: they know who they can do it with

C: its very early and they dont want to bother

[Perpetual Student]

Okay so what do I do, im not going to write orders for the doctor but my DON keeps telling me too

I'd find a different job where I wasn't being pressured to act outside my scope of practice or be deceptive if I were you. It is hilarious that they won't allow standing orders but are pushing you to falsify TOs.

[bagladyrn, RN]

Okay so what do I do, im not going to write orders for the doctor but my DON keeps telling me too

If your DON thinks this is acceptable, suggest that she write the orders and sign HER name to them.

[pagandeva2000, LPN]

If your DON thinks this is acceptable, suggest that she write the orders and sign HER name to them.

Amen to that...she is the autonomous RN (not to be sarcastic towards the great RNs around), but she has the higher license than you, let her take the heat. Now, if she doesn't do that, then, would you want to risk YOUR license for HER? She obviously thinks that it is okay to risk yours...

[HonestRN]

Okay so what do I do, im not going to write orders for the doctor but my DON keeps telling me too

I would simply tell the DON that I didn't feel comfortable writing the orders without first speaking with the Dr. If she insists have her write the order herself and sign it. Protect your license.

[worldqueenie]

I don't understand why you wouldn't just call the doc. At my facility, while it may seem silly to call to get an UA/C&S, when the resident has cloudy, foul smelling urine and altered mental status, it only takes a sec to call and it only takes a sec for the doc to say "yeah, sure". Just cya and call