What are Verbal Orders?

My grandfather is in a nursing home, and he has had trouble in the past getting his pain medications refilled quickly because the DEA did not like to allow verbal orders for this type of refill. We were both glad when the DEA released guidelines to shorten this delay.

Under these guidelines, doctors can authorize long-term care facility nurses to call in oral prescriptions for some medications. Though this does include some pain medications, nurses are still not allowed to phone in verbal orders for morphine.

At this point, he doesn’t need something as strong as morphine, and I am hoping that he never will. These days, he’s getting what he needs when he needs it.

The nurse at the office of my specialist is who I have to talk to in order to get my prescriptions called in when they expire. I am on the blood pressure medication Diltiazem.

My specialist wrote me a prescription for the generic form of this drug called Taztia. He did this to help me save money. However, I couldn't remember the generic name when I called the nurse, and I told her I needed my prescription for Diltiazem refilled.

Well, she took it down word for word, and when she called the pharmacy, she told them I needed Diltiazem. So, I ended up having to pay a higher price, because I needed the medicine right away. I had no time to call and get it corrected and wait some more. Next time, I will remember that she is precise with her verbal orders, and I will ask for Taztia instead.

When I was a child, my mother took me to a doctor's office and filled out the paperwork for me. There was a section on the paperwork that asked what name you go by if it is different than your first name. Well, I went by my middle name, so I ended up in their files with that name.

As I grew older and got my own insurance, I started writing down my first name so as not to confuse doctors, because my insurance card had my first name on it. That same doctor I went to as a child ended up having me in their files as two separate people, and this caused confusion when she sent me to a specialist. He had me down by my middle name because of her.

He called in a verbal order for my prescriptions, and I went to my pharmacy and asked for them by my first name. They said they had no such prescription for that name, so I called my specialist, who said he had already called it in. Come to find out, the pharmacy did have my prescription, but it was in my middle name.

@Moldova - How sad. Pharmacies make the same mistake sometimes and unfortunately many people do die from these mistakes. There really should be a written form when a pharmacy receives a prescription.

Doctors should not be allowed to verbally call in the prescription because any number of things can go wrong, but if the information is written there is less room for error.

@SushiChamp - It is usually nothing to be alarmed with but sometimes verbal orders by doctors can really be harmful if the information in not understood correctly.

I was reading a case about a pregnant woman in Denver that died because the levels of medication that were given to her were at toxic levels. There was a miscommunication regarding the dosage.

The medication was given to her to slow down her contractions, but instead of getting a normal dosage she received four times the normal dosage which slowed her heart rate and eventually killed her.

The hospital then instituted a rule that all verbal orders had to be repeated back to the doctor. This was really sad, but unfortunately unless the physician’s orders are written it can be subject to a small degree of error. Her baby did survive the ordeal, but it was a really sad case.

In the speech and language pathology field, we are sometimes allowed to obtain verbal orders by doctors (while speech therapists diagnose speech and language disorders, doctors often have to prescribe and sign off on their patient receiving speech and language therapy).

The allowance for verbal orders depends on the insurance provider. In the therapy practice I worked for, the therapists would most often still get the written orders from the doctors as the insurance rules changed often and it felt there was less chance of a miscommunication.

@Animalz – It’s probably a good idea to call the hospital and your family doctor, just so you know how they deal with verbal orders. However, I wouldn’t worry about things too much. I assume that medical professionals are much more careful with their work than people who book birthday parties.

A doctor’s job can mean life or death, and most of them take that very seriously.

This thing with verbal orders scares me. I understand that hospitals and pharmacies can’t afford to fax, email, or mail every single communication to each other, but there are so many chances for mistakes when you use verbal orders. I used to work in a place that booked children’s birthday parties over the telephone. We had a verbal orders policy, but some employees didn’t follow it.

Because people didn’t follow the policy, sometimes the birthday child’s name would be misspelled on the cake, or parties would be double booked. It’s bad enough when miscommunications cause trouble at a birthday party, but imagine what they can cause in a hospital!

I’m going to call my local hospital this afternoon and ask about their verbal orders policy because this is really worrying me.