RT Responsibilities Related to Orders and Disagreement with an Order
11. RT Responsibilities Related to Orders
Whether performing an act authorized to Respiratory Therapists under delegation, via an exception or within the public domain, RTs must consider:
the professional Scope of Practice of Respiratory Therapy;
their own personal scope of practice (i.e., competency);
their practice setting (i.e., hospital, community setting) and the policies in that practice setting;
whether they are authorized to perform the ordered intervention (e.g., not prevented due to terms, conditions, and limitations on their certificate of registration);
whether implementation of the order is in the best interest of the patient/client; and
other relevant legislation (e.g., Public Hospitals Act, Integrated Community Health Services Centres Act.).
12. Disagreement with an Order
If an RT receives an order for an intervention that, in their professional judgment, is not in the best interests of the patient/client, then they must not implement the order and make every possible attempt to contact the prescriber to discuss the order. If, after that discussion, the RT is still convinced that carrying out the order would be detrimental to the patient/client, then they must refuse to implement the order, ensure that the prescriber is informed that the order will not be carried out, and document all details related to their decision.
For more information regarding documenting a disagreement, please review the CRTO Documentation Professional Practice Guideline.