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Page modified November 03, 2006

RPNs accepting telephone orders

Q

Can an RPN accept a telephone order from a physician or RN(EC), or an order communicated by a pharmacist? If RPNs can accept phone orders, is an RN required to co-sign the documentation of the order?

A

All nurses can accept telephone orders. However, employers may have policies on whether this activity is part of the RPN role.

The College expects all nurses to have knowledge of the client and the treatment or diagnostic activities being ordered so they can assess the appropriateness of the client order. If the nurse has a concern, the nurse is accountable for discussing the concern with the prescriber. For example, a physician telephones a hospital unit to give a discharge order for a client. The RPN receiving the order should know the client and consider the client’s well-being, possible outcomes of the order and additional client needs prior to accepting the discharge order.

When a nurse is unfamiliar with the client and/or does not have the required knowledge to accept the order, the call should be transferred to a nurse who is both familiar with the client and has the knowledge and skill to determine the appropriateness of the order. For example, a physician calls to order an IV medication for a client. The RPN speaking with the physician does not have the knowledge, skill or judgment to determine the appropriateness of the order or to administer the IV meds. Therefore, the RPN would not accept the order and would transfer the call to a nurse who can determine the appropriateness of the medication and who has knowledge of the client and the client’s care needs.

The College’s Medication practice standard outlines a nurse’s accountability when accepting medication orders by phone. Nurses are accountable for accurately recording the information and assessing the appropriateness of the medication for specific clients. When possible, use a fax to receive orders in writing. Faxes can ensure that documented, signed orders are received in a timely manner and may prevent or reduce the possibility of an error.

All nurses are accountable for their actions. RPNs are accountable for their own practice; therefore, the College does not require an RN signature when an RPN accepts a telephone order.

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