reading doctor's orders

One of the hardest parts of my RN refresher course was reading doctor's orders. I can't believe how much dificultry I had with this. I was wondering if any of your hospitals are using computerized orders??? Has it made a big difference in doing your job? Any hints on how to figure out doctor's handwritings? It was driving me crazy trying to decipher orders. I know it will get easier with experience, but what does a new nurse do in the meantime?
Krisssy RN
All the things a new nurse has to learn can seem overwhelming at first - but don't give up! It will get better with more time. One very important thing is to not be scared or intimidated to clarify orders. We do have one particular Dr. whose handwriting is just unreadable. There were so many complaints that the doc had to go before some comiittee and was required to dictate orders (which were transcribed immediately and printed for each particular unit.) This worked great until the doc slowly but surely tapered off from being compliant with that method. Now each nurse just tries to catch this doc before he leaves the unit to read over his orders with him listening. Great for that particular nurse but not the ones coming on afterward. More complaints may have to be made. Try getting another nurse in your unit to help you work on that particular issue. Do you have a preceptor or have you completed that phase? Make yourself a plan on how to tackle this problem. Anyway - like I said before, just don't be afraid to clarify orders if there is a question - remember - you are responsible for the "5 rights." It really does get better.

At hte old facility I used to work at, there were handwritten orders...a few of which NO-ONE could decipher! Usually had to wait till day shift came on to call that particular dr so it could be clarified.The new facility I am going to has computerized orders...I think I'm gonna like that! Especially since I am working nights again and really get frustrated when we had to wait for days (shift) to clarify.....

We usually take an unreadable order to every nurse, then the unit secretary and then the house doctor. If that fails we call the doc. Of course if the doc just left we call him first. Don't worry- someone usually recognizes the meaning- then it all becomes apparent to the rest of us. Good luck and try not to worry.

I just started a new job as a Specialty Clerk in a hospital, and yes I can say reading the doctors orders is very frustrating. Why do they expect us or should I say how do they expect us to read this chicken scratch. Can't wait till they get a EMR, will make life a little easier at work. I do not understand their frustration when we have to ask, "Doctor could you please tell me what this say?" After all most of them can't read their own writing...

One of our Drs has worse handwriting than a 5 year old would. Drives us nuts! Before he walks away, I make him clarify the order. There have been many occasions that we have had to call.

there should be a prereq class for the MDs, "how to write orders legibly" so nurses can read. LOL...My instructor told me that the reason MDs don't write legibly is because they only know how to spell the first two letters and last letter of the medication. LOL!!

Yes they realy should have a class for MD's to take on handwriting. Someone needs to say to them we cannot read it, and if you get a call, or the Secretaries and Nurses need to confirm with them all the time on what their orders say, then they got noone but themselves to blame. They seem to get very testi when we have to ask. But if everyone is asking all the time, then you would think that with them being doctors with such high levels of education, that they would switch things up somewhat and start writing the orders in a manner we can all read. As if our jobs are not hard enough, with all the paperwork, answering phones, calling for consults and dealing with sick peoples family questions, they just make it even harder by writting chicken scratch that they think we can understand. I just don;t get them...

I'll tell you a secret. Some physicians are very lonely and LOVE to get phone calls from nurses in the middle of the night to alleviate their loneliness. At least that is what i assume. I find that if you wake them up enough their handwriting gets better.

As you spend more time on the job you'll get used to handwriting of your most popular docs, and also guess better because you'll know the protocols. Ask another person and if neither of you can read it, just call.

If you cannot read the order call the Doctor and clarify. This is a patient safety issue.They must be accountable for their own practice. It doesn't matter if it is day or night.

I read a great book by a medical sociologist who studied nurses - his theory, after seeing small crowds of nurses trying to decipher particularly difficult scrawls, was that it's about power: the doctor's too busy to take the time to write legibly, and the nurses have nothing but time to work out what he meant. The author discussed how ridiculous this attitude is, both in terms of wasting nursing time and because of the potential massive consequences for patients.

Sorry...but taking illegible doctor's orders from nurse to nurse, rather than clarifying the order with the MD is like the childhood game of telephone. Always call the MD.