Incomplete Ord…(Orders)

incomplete orders“Are you serious!?!  I can’t believe it, my patient’s in hypertensive crisis and the doc didn’t write an order for BP meds. Well, at least I have an order for Protonix and Colace.”

Over the course of my short tenure as a nurse, I’ve seen some pretty crazy physician orders. I’ve seen orders end mid sentence, unsigned, and unreadable.

I’ve had patients admitted for an illness without pertinent medication orders.

Which means, I must call the doctor and get the orders, which is a waste of my time. After all, they should’ve been ordered in the first place.

Do it right the first time

It’s not just inconvenient for me; it’s inconvenient for my patient.  And sometimes, it’s just dangerous.

If my patient is admitted for hypertensive crisis, wouldn’t commonsense dictate that he/she may need medications to treat it?

If my patient weighs 400 lbs and can’t move, does it make sense for a physician to write an order requiring I get him/her up at night to toilet instead of him/her using the urinal/bedpan?

I don’t know about you, but when I check orders and they aren’t signed, it’s irritating.

It isn’t annoying just because it’s unsigned; it’s annoying because I now I have to dig through the patient’s chart, sift through pages of illegible handwriting, and figure out who ordered them.

Then, after I put the pieces of the puzzle together, I’ve got to call the physician, deal with pharmacy, and defuse an explosive patient.

We’re in the 21st century.  We’ve put men on the moon, eradicated polio, and harnessed the atom.

Yet, for the life of me, I can’t figure out why physicians can’t write their orders, submit them, and sign off on them themselves.

I’m busy, I don’t have time to fax orders to pharmacy; I don’t have time to enter labs into the computer; and I don’t have time to cleanup someone else’s mess.

If I can order labs online, can’t physicians?

It’s absolutely, irrefutably, archaic nonsense.  We’ve let this happen, we’ve let this nonsense continue, decade after decade, year after year, and day after day.

I just don’t get it, why do we put up with it?

Half the time, I call the physician to tell them what I want, which is ridiculous.

In fact, it’s tantamount of me writing the order myself.

“And dammit, I’m tired of incomplete orders!”

If my patient urinates and it burns, stinks and looks cloudy, do I really need to call Captain Obvious on the phone?

If my patient has a headache and isn’t allergic to acetaminophen, should I need an order to give Tylenol?

I’m not suggesting physicians aren’t needed.  And I’m not writing this to bash physicians.

After all, my uncle is a physician and I almost became one myself, but it doesn’t mean I’m letting them or the system off the hook.

It’s time to change; it’s time for reform; and it’s time to enter the new millennium.

I’m an agent of change; you’re an agent of change; we’re agents of change; and it’s time to change.

I’m a militant nurse. I’m tired of the traditional chains which bind us. I’m tired of the artificial and archaic social healthcare hierarchy.And dammit, I’m tired of incomplete orders!

What’s the worst written order you have read?

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