Verbal order (VO)
Formal Definition
A medication or treatment order given orally by a licensed prescriber (typically a physician) to a nurse or other licensed clinician to be carried out before a written or electronic order can be entered; allowed only in specific circumstances (emergencies, sterile procedures where the prescriber cannot break scrub, certain EHR-down scenarios), and must be co-signed by the prescriber within a defined institutional timeframe (often 24-48 hours).
How It's Used on the Ward
"VO" or "verbal order" — used when the prescriber can't write/type the order themselves (emergency, in the OR, scrubbed in) and needs the receiving nurse to act immediately; the most common scenario is codes, where the team leader shouts out medication orders and a recorder nurse executes them.
Example
""Code leader: 'One of epi IV push now.' Recorder: 'VO received, one of epi IV push, time 14:37, read back confirmed.' Nurse pushes 1mg of epinephrine. After the code resolves, the team leader must electronically sign all VOs within 48 hours.""
Clinical Context
Regulatory rules (Joint Commission, state board of nursing): VOs are restricted — for non-emergent inpatient medications, written/electronic orders are the standard. Acceptable contexts: emergency/critical care situations, sterile procedures where prescriber is scrubbed, intra-op orders during anesthesia, computer downtime. Best practice: read-back required (see "read-back/cafe"), prescriber must later sign/co-sign. Some institutions have policies further limiting who can accept VOs (often RN, charge RN, unit clerk). Student role: students cannot accept or give verbal orders in most institutions — the receiving nurse must verify with the licensed prescriber. Verbal orders used inappropriately (without co-sign) are a Joint Commission citation and a patient safety risk.