Would you call this prescribing?

[SouthernLPN2RN, MSN, RN, APRN, NP]

I work in an office setting that uses computer charts for our pts. Any time one of them calls requesting a med refill, it's put in the computer and routed to the nurse. I always route these requests to the MD, as I don't feel that it's my place to call in meds on a pt without their ok. We do keep med lists in the chart, and for the most part, they are accurate. My problem is one doc and his nurse "T". This particular doc doesn't keep his med lists updated or accurate. His nurse will call in rx's w/o his ok and will print rx's for his signature on controlled meds (I don't even go that far). He likes it that way and so does she. I feel that this could be a liability and I absolutely refuse to do it. I had to work with him for 3 months while she was out and we constantly nah-nah'd back and forth over my unwillingness to do these things for him. On a written rx, the doc has to sign, but on one that's called in, it appears as if the md okayed it when they really haven't. I just feel like this has the potential to come back and bite someone on the butt should it ever come up in a legal situation. What do y'all think?

[CrunchRN, ADN, RN]

Make the doctor initial any meds you call in for him. Otherwise you are exceeding your scope. Good luck.

[ImAnMa]

I work in an office setting that uses computer charts for our pts. Any time one of them calls requesting a med refill, it's put in the computer and routed to the nurse. I always route these requests to the MD, as I don't feel that it's my place to call in meds on a pt without their ok. We do keep med lists in the chart, and for the most part, they are accurate. My problem is one doc and his nurse "T". This particular doc doesn't keep his med lists updated or accurate. His nurse will call in rx's w/o his ok and will print rx's for his signature on controlled meds (I don't even go that far). He likes it that way and so does she. I feel that this could be a liability and I absolutely refuse to do it. I had to work with him for 3 months while she was out and we constantly nah-nah'd back and forth over my unwillingness to do these things for him. On a written rx, the doc has to sign, but on one that's called in, it appears as if the md okayed it when they really haven't. I just feel like this has the potential to come back and bite someone on the butt should it ever come up in a legal situation. What do y'all think?

I am somewhat familiar with electronic medical records, each person has a sign on that is theirs alone and should include what amounts to thier signature, also each Dr should have a standing protocol as to refills that their nurse should approve and that the nurse and MD have discussed, it should be discussed and posted.

for medications such as cholestrol or hypertension meds the protocol of the MD i work with is to see when the last labs were and when the last office visit was, for example- with the MD i work for the labs would have to have been done within the past year for hypertension and within the past 6 months for cholestrol. also you then look at the last office visit and see when they were to follow up for a visit with MD if they are within that time frame I am allowed to refill up until that time if the criteria is not meet then it is routed to the MD for auth. as for controlled medications they are and should be all routed to the MD for auth when they ok it they can print it out and you can give it to them to sign. Following a written protocol is within the scope of a nurse as well as an MA ... communication is key however.

JMHO - I wonder if a protocol has even been discussed in your office ? If not perhaps you could bring it up and open the door for this.