I Didn't Pull An Order For That Out Of My Rear End

1 Hi all. I am having a heck of a time with another agency who also is in the homes caring for patients. I work hospice, and I am only with a patient a few hours a week. This other agency provides 12-24 hour care in the home for some of our patients for diaganoses not related to hospice. These nurses, bless their hearts, are with one patient for many hours and have to deal with the families of said patients. Some of them are great and get hospice and what we're doing. But some of them constantly stonewall everything hospice tries to do. My main issues are with medication administration. The nurses from this company will not give medications if they don't have an order written by the physician in the home. Some will not accept verbal orders written down as being official orders since they don't have the physician's signature on them. My issue is that if a medication shows up at a patient's house with his/her name on it, the physician's name on it, and is obviously sent from a pharmacy, WHY do they need official orders to give it?????? Isn't it a given that there ARE orders for it to be administered if it has the patient's name on it and is current???? Our doctor is not available to write out orders most of the time. He is available by phone for verbal orders which he signs at a later date, but we can't wait for that when a patient is having 10/10 pain. Am I being unreasonable? Is there a legal issue with all of this that I'm not understanding? Any advice appreciated.
They may be referring to Section 5 of the DEA's "Practitioner Manual" that requires a prescription for all CII meds. The DEA specifies that an order for a CII is not a prescription and gives specific requirements for a prescription.

I can understand your issue. They may be simply verifying the physician's original order. Just in case, an error has occurred in transcription by whomever: doctor, nurse, pharmacist.....

Quote from Asystole RNThey may be referring to Section 5 of the DEA's "Practitioner Manual" that requires a prescription for all CII meds. The DEA specifies that an order for a CII is not a prescription and gives specific requirements for a prescription.

Could the solution here be standing orders for each hospice patient for predictable symptoms - breakthrough pain, nausea, increased secretions, constipation, etc.? If these orders were written for each patient admitted to hospice it might avoid the issue of a lack of a written order.

So, the MD phoned pharmacy and ordered a narc. Narc was delivered to pt. home. The primary caregivers (RNs ?) will not give these meds?! What are they looking for that is not already on the script bottle? Do they give BP meds, or even insulin? If so, what is their rationale for giving those meds then? I don't understand what they want? They must assess for many other drugs as well as narcs.

Quote from Asystole RNThey may be referring to Section 5 of the DEA's "Practitioner Manual" that requires a prescription for all CII meds. The DEA specifies that an order for a CII is not a prescription and gives specific requirements for a prescription.

Quote from mortehowever, the pharmacy would have been in receipt of the script, prior to the dispensing of the med......there for that base has been covered.

Quote from mortehowever, the pharmacy would have been in receipt of the script, prior to the dispensing of the med......there for that base has been covered.

Quote from 2ndwindSo, the MD phoned pharmacy and ordered a narc. Narc was delivered to pt. home. The primary caregivers (RNs ?) will not give these meds?! What are they looking for that is not already on the script bottle? Do they give BP meds, or even insulin? If so, what is their rationale for giving those meds then? I don't understand what they want? They must assess for many other drugs as well as narcs.

OK, well shows ya how long ago last I worked for an MD. (seriously cramps this guy's style, I can imagine. Private practice, loves baseball...). Huh, PDA sending of? He'd do that in a second. I am sure there is an app for that.