Which to follow: MD or Policy?

2 I work part time at an LTC facility. We have a clear policy that states when a patient is transferred to the hospital and stays out of our facility for more than 24 hours, the orders at our facility must be discontinued and new orders written. A returning patient happened to come back on the 25^th hour. The charge nurse told me that the MD didn’t want to be bothered with discontinuing and writing new orders since the patient returned just an hour outside of the 24 hour window. She then said she’s just going to follow the MDs old/current orders because that’s what the MD instructed, and she didn’t want to bother herself with transcribing the same exact orders.

Would you follow the policy (which could use some revising IMO) or just follow the MDs current orders?
Quote from newboyI work part time at an LTC facility. We have a clear policy that states when a patient is transferred to the hospital and stays out of our facility for more than 24 hours, the orders at our facility must be discontinued and new orders written. A returning patient happened to come back on the 25th hour. The charge nurse told me that the MD didn’t want to be bothered with discontinuing and writing new orders since the patient returned just an hour outside of the 24 hour window. She then said she’s just going to follow the MDs old/current orders because that’s what the MD instructed, and she didn’t want to bother herself with transcribing the same exact orders.Would you follow the policy (which could use some revising IMO) or just follow the MDs current orders?

There's actually a third basis for decision making that takes precedent over both the MD and policy which is nursing judgement. In this situation I'm not sure there's much of an option, it's the MD who is choosing not to rewrite the orders not you. If your nursing judgement told you to force the issue, then you could D/C all of the previous orders regardless of the MD's preference, but while you can D/C them per policy, you can't write new ones per policy, so that only leaves you (and the patient) with no orders, which overall may not be better for the patient.

I would follow policy . Can never go wrong with that in my opinion.

He really doesn't need to rewrite the orders. He could just give an order to resume all previous meds.

I can't tell you how many times the nurses have been fighting with the MDs because they didn't want to follow the policy. I agree in some cases, its not that big of a deal. There was an incident a couple of months back where the time span was much greater and the nurses were still following the old MD orders. Everyone who gave meds were written up for administering medication without an MD order.

When in doubt follow policy. If the MDs have a problem with , oh well.

Quote from prnqdayI would follow policy . Can never go wrong with that in my opinion.

Quote from loriangel14He really doesn't need to rewrite the orders. He could just give an order to resume all previous meds.

Why would you not resumed the medications as ordered? If that was my patient, and orders were held for that reason, I would be livid. Sent from my iPhone.

Quote from BostonFNPWhy would you not resumed the medications as ordered? If that was my patient, and orders were held for that reason, I would be livid. Sent from my iPhone.

Quote from BostonFNPWhy would you not resumed the medications as ordered? If that was my patient, and orders were held for that reason, I would be livid. Sent from my iPhone.

Quote from macawakeFrom what I understand of OP's post there's a policy in place that states that the physician first has to discontinue the old order and then write a new one and this apparently hadn't been done. Seems like a cumbersome policy to me and amending it seems like a good idea. It does seem to give both the nurses and the providers headaches