New RN - what would you do?

[knitnurse72]

I recently finished school in December and passed the NCLEX in January, and began my first job as an RN about 3 weeks ago. Even though I am a new nurse, I have worked in healthcare in one way or another for almost 20 years, and I guess I always expect a certain level of professionalism from myself and from those I work with, although it doesn't always happen. Anyway, a few days ago something happened that I was very uncomfortable with as a newly licensed RN, but I don't now if this is something that happens in long term care.

I have been orienting on a sub-acute unit at a LTC facility. There are 2 NPs who come in 3 days a week, and my personal opinion is that neither one is really that great, compared to other NPs I know, but that's okay - there are good and not so good people in every job. The nurse I was training with the other day had to call one of the NPs to get some scripts for a patient who was going home. The NP, instead of calling them in herself, from her office (it was 2 in the afternoon), gave the nurse her DEA # and said she could "just call them in." The nurse training me asked if I wanted to do it, but I said no - I was very uncomfortable calling in prescriptions, as I am not able to prescribe. Then later I thought about what if I did call (or the other nurse), and I/we decided to order all kinds of scripts under this NPs name and go pick them up, since we had her prescriber #??!! My last job was as a unit secretary at a hospital, and I never once saw a nurse calling in a script like that - faxing them to a pharmacy, yes, but not this.

Is this a common practice in long-term care, or is this something people can really get in trouble for? Thinking about it still makes me uncomfortable and I don't think I would do it in the future if this situation arose again.

[BSNbeauty, BSN, RN]

I've never called scripts in when I worked in sub acute. The NPs and Docs filled out the prescription order form with their DEA#, signature and etc. Nurses simply faxed them in.

[BSNbeauty, BSN, RN]

Check your hosptial policy and BON policy. Doesn't sound right to me.

[pre-nurseshan]

At the dental offices that I have worked at, we've regularly called in rxs that the dds rxd. It's not really a big deal.

[HippyDippyLPN]

Strange that some people think its ok and others not. I have never been in a clinic setting where the Md's call their own RX's in. Especially now with electronic charting, the only thing us nurses called in were narcotics.

[CapeCodMermaid, RN]

We do NOT call in any kind of scripts...ever. Do you realize the DEA is trying to prevent NPs and PAs from writing scripts for any drug containing hydrocodone??? The kind of practice you're describing gives them the kind of ammunition they'll need.

[Ayvah, RN]

We do NOT call in any kind of scripts...ever. Do you realize the DEA is trying to prevent NPs and PAs from writing scripts for any drug containing hydrocodone??? The kind of practice you're describing gives them the kind of ammunition they'll need.

The FDA panel is recommending moving hydrocodone to schedule II category if that is what you mean; this would make hydrocodone scripts ineligible to be faxed or called in to the pharmacy (a paper script would be required to be hand delivered to the pharmacy).

It is common practice for a nurse in a clinic to call in a general or schedule III prescription - you are not prescribing it yourself, you are acting under an order from a practitioner and delivering the information for the pharmacy to prescribe the drug under the doctor's name. Having the DEA number gives the pharmacy confirmation that it is a legitimate script. Doctors must give the DEA number when they call in a script too.

Think of it this way, doctors give verbal orders to dispense medications to patients in the hospital or nursing home, and the nurse in turn gives the information to the in-house pharmacy to dispense the medication to you so you can give it to the patient. Its not a whole lot different to do it with an outside pharmacy, they just need the DEA. Obviously verbal orders are not ideal due to the potential for errors in transmission of the information.

OP, having been bestowed a license means that you have the responsibility of having sensitive information (and easy access to drugs, etc) and you are held to the high standard to not misuse that. DEA numbers are not given out to the general public, but to a licensed nurse is a different story. There is nothing unusual about calling in a script when you have a legitimate order to do so.

[LynnLRN]

The DEA is usually written on scripts so even the patient can see it if they are given the script themselves. I called in scripts all the time after they were written.

[itsnowornever, BSN, RN]

I am in L&D and do it for our doctors regularly

Posting from my phone, ease forgive my fat thumbs! :)

[itsnowornever, BSN, RN]

For years I called in scripts as an MA in an orthopedic surgeon practice and I've also done it as an RN. I speak directly with the pharmacist and get their name and they get mine. You aren't prescribing you're essentially "dropping off" the RX for the patient. Of course, each state or facility may be different. We keep the written RX from the MD in the chart.[/quote']

This

Posting from my phone, ease forgive my fat thumbs! :)

[Swellz]

I work as an office assistant at a PCP's office and we call in rx's all the time. I'm in nursing school and recently quit from being a pharmacy tech for more than 6 years, so I'm comfortable with it. However, none of the other receptionists have any medical training. The nurses at our office wouldn't have time to call in the prescriptions, not with the current set-up anyway.

[Ella26, BSN, RN]

I have worked clinic and LTC, while I have called in scripts in LTC, in the clinic the nurses/ma's called in RX's, the md's never did their own.

I work in a clinic also and we call in rxs for the MDs. But like others have said its per facility policy/protocol.