[IL-CNM:769] Re: Inpatient Pharmacy Orders

humber humber at gateway.net
Thu Mar 9 13:03:37 CST 2000


Check in your hospital bylaws, they frequently delineate what needs
co-signature for your particular institution.

-----Original Message-----
From: Darryn Dunbar <ddunbarcnm at yahoo.com>
To: Discussion List for Certified Nurse Midwives in IL
<IL-CNM at phaedrus.wt.luc.edu>
Date: Thursday, March 09, 2000 10:49 AM
Subject: [IL-CNM:767] Inpatient Pharmacy Orders

>Hi All,
>Was cornered by the Director and Assistant Director of
>the Pharmacy yesterday b/c we've been writing all
>orders just signing our name to them.  They called
>IDPR and were told that nurse-midwives are *not*
>independent prescribers, which is correct, we have
>delegated authority.  As a result, they want a
>physician's name w/ all of our inpatient med orders.
>When they stormed my office (the door was open), I was
>meeting w/ one of my back-up physicians who was unable
>to make last week's meeting...they cared not and
>proceeded w/ their agenda.  It all happened rather
>quickly and all they were looking for was a quick
>solution, which they got as I said, fine, we'll put
>the docs name next to ours.  Mind you, I'd been up
>since 0130 for a primigravida that I admitted who went
>on to birth at 1316.  This was about 5pm when I was
>After a night's rest, it occurred to me that my backup
>physicians will now have to sign those orders either
>while the patients are in house or in medical records
>after the discharge.  This will not be acceptable to
>them.  I had a meeting w/ my VP this a.m. and told her
>of the idea I had:  our Clinical Practice Guidelines
>(which include an "Inpatient Formulary" and "Standing
>Orders") have been signed by the chair of OB/GYN,
>approved by the dept. of OB/GYN, the medical staff,
>the executive committee and the BOD and we have a
>signed collaborative agreement w/ our four backup
>physicians; shouldn't this be enough...that our
>physicians approve of us writing these orders and that
>only when we write an order for a medication *not* on
>the formulary listed in the guidelines should we need
>a physicians co-signature?
>What say you all on this issue?  What happens in your
>hospitals?  I don't see why the collab. agrmnt. and
>the approved formulary won't work...however, maybe
>someone can point that out to me.
>Would appreciate any and all input!
>Take Care,
>Darryn W. Dunbar, RNC, CNM, MS
>Joliet, IL
>"Every Woman Deserves A Midwife!"
>Do You Yahoo!?
>Talk to your friends online with Yahoo! Messenger.

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