ORDER WRITING POLICY

1. The order writing policy described herein is reflective of all the teaching hospitals in which the renal fellows participate.  The policy is also reflective of the Internal Medicine Training Program.

2. Routinely, the medical house staff enters all orders for the patients for whom they are caring. 

3. This is done to facilitate teaching and instruction and to centralize the medical ordering as a precautionary measure. 

4. Nephrology fellows enter orders for procedures and treatments that require subspecialty expertise and that are beyond the scope of internal medicine training.  These include:  acute and chronic hemodialysis, peritoneal dialysis, continuous renal replacement therapy, and the monitoring of a patient undergoing renal biopsy.

5. Nephrology fellows on the PMH transplant service enters all orders for patients whom there are caring.  The St. Paul Transplant fellow writes orders in conjunction with other members of the transplant team.

5. Attending physicians may only enter orders on teaching patients in the unusual circumstance when the fellow is unavailable and patient care could be compromised by any delay.  Attending physicians are expected to discuss these orders with the fellow and house staff caring for the patient.