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Have you ever REFUSED to complete a doctor's order, and how did you go about discussing it with the doctor?

January 13th, 2022

Yes, I have refused before because I was not comfortable with the medication ordered. I discussed my concerns with the Dr, calmly explained after getting yelled at and the prepared the medication for the Dr to administer himself. Which he did not. He changed the order to a safe dose and I then administered.

You have to protect your own license however there is a line that you have to remember. They did go to medical school and we did not. There may be new research, it could be uncommon to us but not to them - direct communication and questions without attitude and an open mind are necessary.

January 13th, 2022

You might go through the pharmacist on staff as well for clarification and if there is a problem with the order the pharmacist could discuss with the physician

April 26th, 2022

Many Times. Nurses have a Responsibility to Assure that orders are Correct. If not, it is your Duty to address it. U cannot be intimidated by Irate Docs. Most Facilities these days, do not Tolerate impediments to Safe Patient Care. That includes Yelling Docs!

April 26th, 2022

I have refused physician orders many time over the last 45 years. I havewritten orders as an NP that were refused. If I could not help the nurse understand the order was valid, assured mistake was corrected, then I did it myself. Then worked through any nursing issues.

There are time the order is blatantly dangerous, poorly written, for the wrong patient, or violates the law or organizational policies. Most of the time a quick call get the order changed.

Then sometimes .... I worked nights in an ER many years ago, I was not the charge nurse but I was the senior nurse on duty that day and stepped in, the doc was, well, a little off. I had about 2 years ER, SICU, and CCU experience by that time.

We had a, large for age, 14 year old boy with a fractured arm who was casted and to be sent home. The order, so the child could sleep, was for 100 mg of Seconal and 100 mg Demerol IM. The PDR showed Seconal: 1. is administered IM ONLY in the hospital setting, 2. was never mixed with an opiate. Demerol IM was also only used in a hospital setting. and certainly never on a pediatric outpatient.

The charge nurse (at that time we did things no longer allowed - was a graduate nurse not yet licensed) asked me about the dose. I questioned the doc and he tried to explain it away as perfectly safe. I told the doc since I was senior nurse on that shift NO ONE on the nursing staff would give the order as it was dangerous and way outside safe parameters. He went ballistic, said all kinds of nasty stuff of course. I told him if he believed in what he was doing I would pull the meds for him and he could give it. He Did that signed the chart with a Big Flourish "GIVEN BY nnnn MD BECAUSE PAUL KAPSAR RN REFUSED" I thanked him tossed the chart under the ED managers door and told her to deal with it. I found out later in the shift he had also ordered that same dose for someone else that shift and one of the LPN's had not questioned it. Manager got that chart too.

The doc no longer worked in that ED by the following week.

September 24th, 2021

First of all was it an incomplete order. Sometimes doctors forget to add specific maybe the route of a medication or frequency. In any event just contact the doctor and asked what he wanted. Why? Because you don’t understand the order based on what’s written. Have him/her clarify the order and you can a T. O. Make sure when the doctor comes in he/she sign his T. O.

September 23rd, 2021

It was a medication order. I consulted with the pharmacist, got his opinion, then I advised the house supervisor that I was going to notify the Dr of my refusal as well as all other nurses on the unit. I suggested he could call a resident to see if anyone was willing to give the med at the very high dose that was ordered, or he could give the medication himself. After I notified the physician, I documented my steps.

September 24th, 2021

As a nurse you can't just refuse to complete an order. You can talk to the doctor to get clarification. If you are uncomfortable with the administration of whatever the drug is or the ordered treatment you should have a more experience charge nurse on staff to consult with or she can help or administer the med. Having a questioning attitude and a mind set for learning will serve all nurses well. Maybe the doctor made a mistake and just clarifying with him will be useful. Since I don't know specifics it's hard to comment anything that might be too helpful to your situation. I am an NP, I have been a nurse for over 15 years, and a NP for over 5 years. I can tell you just refusing to do something will never look well on you as a nurse. I have had plenty of nurse friends get fired over this. Good luck!