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Misunderstood physician? Patient may be harmed
If you're taking a verbal order from an emergency physician, remember that there is always a potential for miscommunication, warns René Borghese, RN, BAS, unit educator in the ED at Duke University Medical Center. "This is the primary reason we utilize them only when absolutely necessary," she says.
Even with electronic documentation, however, verbal orders are often needed during a cardio-pulmonary arrest or trauma situation, says Borghese. "Tension is sometimes high during these scenarios," says Borghese. "Miscommunication could be detrimental to the patient, if the wrong medication or treatment were given."
Repeat orders prior to carrying them out to verify for correctness, advises Borghese. Here are other scenarios that can lead to errors:
Consultants or resident physicians may not be familiar with the flow of the ED.
"Additional effort on the part of the emergency nurse is sometimes necessary to ensure all orders are appropriate," Borghese says. Rely on a strong clinical knowledge base in order to recognize and question orders that might not be optimal, she adds.
"The emergency nurse must have the fortitude to initiate communication with all levels of providers," says Borghese.
Patients may have similar names and/or diagnoses.
"Verbal interaction, followed by documentation of pertinent events, will ensure the safety of our patients," Borghese says.
The ED physician may be experiencing numerous interruptions.
"When possible, the nursing and medical staff should have close physical proximity to one another," says Borghese. "This fosters an open communication model."
For more information on improving communication with ED physicians, contact: