As I mentioned in a recent post, during my residency, we took call from home. That meant that nurses could call us with issues about cross cover patients all night long, and we still had to work all day the next day.
Early in the year, several of us residents noticed that practically every night around 11 or 12, we were getting called about several of an attending named Dr. Brown's patients. It was always the same thing: "Can we give Mrs. Smith something for sleep?" And we'd give a verbal order for Ambien then go back to sleep ourselves.
(The ultimate insult is getting woken up from sleep to be told that a patient can't sleep. And then you can't get back to sleep. And you can't take anything because you're on freaking call.)
Since all the admission orders had a check-box to give Ambien for sleep, we finally cornered Dr. Brown's resident and asked him why he wasn't checking off that box. He said that Dr. Brown wouldn't let him, because she wanted to know if the patient had trouble sleeping and asked for a sleep medication.
Because there's absolutely no way to tell if a patient got a PRN order overnight unless you make the person on call give a verbal order for it.
Eventually, we bullied the resident into telling Dr. Brown that he was going to be checking off that box from now on.