I am a recently licensed LPN in FL. I have been working at a small primary care clinic for about 2 months. Some of our practitioners prefer the nurse to write the patient's refill Rx's on the prescription pad for them so that they can just sign it. At first, I thought it was no big deal. Just writing the prescription over, as it had already been written, and just the long term meds, like for HTN, or DM, not pain meds. When patients request refills by phone, some prescribers do not complete prescriptions for call in, omitting the strength, quantity, and amount of refills, expecting the nurse to figure it out based on previous prescriptions. I now feel like the prescribers are expecting me, the LPN, to write their prescriptions for them, and I do not feel comfortable. Today, I had some patient's requesting pain medications and psych drugs that I did not feel comfortable writing, so I didn't. The prescriber sent the patients back to me with a blank, signed prescription slip, telling me to fill it in. I really want to know what the rules are about this. Has anyone ever been in this situation? I have looked at the FL BON Nurse Practice Act, and I can't find it. I don't want to lose my license because the practitioner doesn't feel like writing.
Jan 19, '10
You're not prescribing the medication, you're just writing it out on a prescription pad, so I'm pretty sure it's not a scope of practice issue. I'm also in Florida, work in the clinic setting, and have done this numerous times. However, now most of our refills are done through EMR. Does your clinic not use EMR yet? I love it because it shows the history of what has been previously prescribed and refills can be faxed directly from the system (except for schedule 2 drugs obviously).
As far as the prescriber sending the patients back to you with a blank, signed script...wow. They had it in their hand and couldn't even fill it out
Have you talked to the prescriber and told them you're not comfortable with this?
Jan 19, '10
Wow...that's exactly what I thought. This prescriber was trying to be a smart***, because I didn't write his scripts, but seriously... One of our 5 prescribers uses EMR, and it seems to be a lot easier, even for calling it in, because at least it is a complete prescription.
Jan 19, '10
funny you should ask that, a few weeks ago i had a resident who was discharging a patient and he forgot to write one of her scripts, so i had him paged and let him know he needed to come back up the floor and write it out and sign it so she could go on her merry way. he asked me if i could just get the pad out from the med room and do it myself. i'm a new grad who isn't even off orientation yet, so i asked the charge nurse and she was outraged that he would even ask me lol moral of the story is, that is the prescriber's job!! it's definitely not your responsibility to do it, pretty much it's just them being lazy.
Jan 20, '10
Dont do it! In the facility I work in we need a Dr. order for milk of magnesia. Call them and get a telephone order so then all they have to do is sign it. You will lose your license if something goes wrong. Believe me the doc will not put his license at stake for you and neither should you. From one new grad to another, DO NOT trust anyone!
Jan 21, '10
user 345678..so sad..so true...trust NO ONE! Drs will throw you under the bus in a NY minute, no second.
Jan 22, '10
I know of many physicians who do this. This I think is starting to go away with the EMR, but whenever I was asked to do so I always refused. I did not go to medical school, and I do not get paid the big bucks, so I am not doing it..
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