The nurse receives an order from the primary care provider that the nurse believes would be harmful to the client. What should the nurse do to meet her legal obligation to the client?
1. Carry out the order as written, because the provider knows best.
2. Document in the medical record that the order wasn't carried out, and why.
3. Contact the supervisor to discuss the order and the nurse's concerns.
4. Just ignore the order, and document that it was not carried out.
3
Rationale 1: While the nurse has an obligation to carry out the provider's orders, the obligation to the client is more important. A nurse who carries out an order that harms the client shares the same liability and responsibility as the provider, so the nurse must consult the supervisor to discuss the order and the nurse's concern. If the supervisor cannot satisfactorily explain the safety of the order, the physician must be consulted. Ignoring the order would not serve the client, and disagreements with the plan of care are not documented in the legal record but resolved between members of the health care team.
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