What Is a Standing Order? - Definition & Examples

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  • 0:00 Standing Orders
  • 2:44 Benefits of Standing Orders
  • 4:14 Lesson Summary
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Lesson Transcript
Instructor: Bethany Lieberman

Bethany is a certified OB/GYN nurse who has a master's degree in Nursing Education.

In this lesson you will learn about a medical term called a standing order, including what it means and how it is used collaboratively between nurses and physicians to improve efficiency and meet the needs of their patients.

Standing Orders

It's a full moon on the labor and delivery ward, which means many babies are sure to be born tonight! Soon after shift report is over, Mary is the first patient to arrive at triage. She is pregnant with her third child and has already been in labor for two hours when her water broke. The triage nurses checked her cervix and determined she is already eight centimeters dilated -- she needs to be admitted to the labor and delivery ward as soon as possible. Janet is the first nurse to take an admission tonight and prepares to get Mary checked in.

Janet is aware that she must move quickly to admit Mary before her baby is born. Janet seamlessly helps Mary change into her hospital gown, performs a head-to-toe assessment, starts an intravenous line, obtains lab work, and begins an antibiotic infusion. Simultaneously, Janet is able to monitor Mary's baby and help her manage her pain by helping her focus her breathing during contractions. Janet is able to perform all these measures without ever leaving Mary's side to pick up the phone and obtain an order from the doctor. She is able to remain at the bedside and provide patient-centered care, or care personalized to the specific needs and desires of the patient, because she has standing orders from the physician to guide her actions.

Nurses must follow the verbal and written directions, called orders, that are given to them by physicians in order to be administering lawfully acceptable nursing care. Doctors write the orders, and nurses carry them out. For a patient in labor, for example, a doctor will even have to write an order to admit her to the labor and delivery ward when she is deemed to be in active labor. The nurse cannot decide herself to admit the patient, even if it was the nurse herself that made the determination that the patient was in labor in the first place! The physician must give the order first.

In order to provide safe and efficient care, nurses and physicians collaborate and develop a set of standing orders. Nurses and doctors work together as team members with a common goal of providing the best care for their patients by deciding upon a set of these orders, where if a patient meets a certain criteria, a standing order can be followed without having to call the physician.

For example, on the labor and delivery ward, Janet's standing orders may state that for patients with cervical dilation greater than five centimeters, the nurse may admit her to labor and delivery, begin electronic fetal monitoring, start intravenous access, and obtain complete blood count, urinalysis, and urine culture. There may even be a standing order for pain medication to help manage contraction pain in labor that is agreed upon by the nurse and doctors.

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