Questioning Orders: Does the Doctor really know best?

As a nurse it is not only your right, but your responsibility, to question any order you believe to be inappropriate.  You have a statutory obligation to advocate for the patient.  In looking out for your patients’ best interests you should never turn a blind eye to a questionable order, assuming that “the doctor or mid-level practitioner knows best.”   Keeping mum in this situation could be viewed as negligence, leaving you vulnerable to disciplinary action against your license or a malpractice claim.

The most glaring situation is when an order could compromise patient safety. This could include an order for a contraindicated drug, or the wrong dosage of a correct drug.  Examples that come to mind are drugs that are contraindicated by patient allergy, laboratory values, or other medications currently being administered to the patient.  Additionally it is not uncommon to receive orders with miscalculated heparin or potassium doses.  As a nurse, you should also be alert for orders that do not meet the generally accepted standards of care or violate a hospital or employer policy or procedure.  You should always question an unclear or illegible order.  If the order is unclear to you, do not guess or assume, get the order clarified by the practitioner who wrote the order.

Questioning a practitioner about his or her orders can be uncomfortable.  However, facing disciplinary action against your nursing license for carrying out an inappropriate order will be downright painful.  When questioning an order, be concise and provide specific reasons for your inquiry, such as a drug label’s indication that the dosage ordered for your patient is dangerous. Be respectful but firm and professional, and don’t back down until you are convinced the order is safe. If the doctor will not change the order, ask for an explanation or solid documentation to support his or her decision. Always thoroughly document your objections, the person with whom you spoke about these objections, and what ensued. If you still are not satisfied, elevate the issue to a charge nurse, the nursing supervisor, or director of nursing.

As a nurse, you should never follow an unsafe order. You are statutorily obligated to protect the patient.  Carrying out a questionable order may compromise patient safety and may leave you to face disciplinary action against your nursing license and/or malpractice claims.

This post is intended as informational only and does not constitute legal advice. If you, or someone you know is facing disciplinary action against their nursing license, consult with an experienced Colorado Nurse Defender before making any statements.

The Law Office of Karen M McGovern, LLC, is an experienced law firm specializing in Colorado nursing license defense . Call 303.260.6444 for a free consultation or contact us through our website – www.mcgovernlawoffice.com.

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