Orders

[Iamnew2]

For those of you in inpatient rehab work, who does the admission/discharge orders? Do you guys as attending do them or does the nursing staff do them?

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[piviti]

For those of you in inpatient rehab work, who does the admission/discharge orders? Do you guys as attending do them or does the nursing staff do them?

At our hospital, we do the admission orders and medicine does the discharge orders. For after hours admissions, the nursing staff puts in the meds and calls us to verify orders.

 

[Iamnew2]

At our hospital, we do the admission orders and medicine does the discharge orders. For after hours admissions, the nursing staff puts in the meds and calls us to verify orders.

Are you a resident or an attending? If attending, you manually put in the orders including the meds during the day? And for the night admissions, nurses essentially go over the meds and you either approve or disapprove?

 

[piviti]

Are you a resident or an attending? If attending, you manually put in the orders including the meds during the day? And for the night admissions, nurses essentially go over the meds and you either approve or disapprove?

I’m an attending, the pharmacist puts in the meds in the system and we have to cross them over and add in the generic admissions orders (PT/OT/prn meds). And that is correct about night admissions.

 

[DMBandFan86]

I just get called by nursing and review over the phone. Takes 1-3 minutes per patient. I do my H&P next day and make any changes to meds then. Otherwise meds are written down on paper and the internist signs off on them. Discharge orders are mostly done by internists, but I go over everything with the patient.

 

[Iamnew2]

I just get called by nursing and review over the phone. Takes 1-3 minutes per patient. I do my H&P next day and make any changes to meds then. Otherwise meds are written down on paper and the internist signs off on them. Discharge orders are mostly done by internists, but I go over everything with the patient.

Interesting. That's what I suggested and requested, and how I am used to doing orders too. I almost had a revolt at one point because the nursing staff didn't want to do it and said well it's the physician who has to do all this. I was like what? So it seems the compromise right now is that the nursing staff puts in the admission orders, and the pharmacist puts in the meds and I have to go through the med rec and approve them and reconcile them in which takes a ton of time.

 

[RangerBob]

I do admit and dc orders. RNs doe the med rec and I select continue/discontinue for all. Have to be careful as they can get doses wrong sometimes. Then I put in our standard admission order set and tailor a few things in it. Takes a few minutes. Typically orders are signed/held and RN will release them when pt arrives.

We do all dc orders as well.

Patients are admitted typically between 11 and 6pm and dc between 10 and 2pm.

 

[DMBandFan86]

My admissions come anytime. Most frequently between 8 pm - 11 pm, sometimes earlier or later. Couldn’t imagine having to get on a computer that late to put in orders if my nursing staff didn’t do it. I would find a different job or they would have to pay me a lot of extra

 

[Iamnew2]

My admissions come anytime. Most frequently between 8 pm - 11 pm, sometimes earlier or later. Couldn’t imagine having to get on a computer that late to put in orders if my nursing staff didn’t do it. I would find a different job or they would have to pay me a lot of extra

Yeah I agree. I guess the nurses at my current gig weren't used to doing that. So initially a lot of resistance but now they put in the orders and then call me when the meds are ready and I sign off on stuff.

 

[lejeunesage]

I do all my own admission and discharge orders. Nursing isn't involved at all, except insofar as they release the orders after the patients arrive. My nurses union would have a major freak out if I ask any nurse to get involved in med rec or entering orders.