Can NPS write prescriptions for themselves and Family? Can NPS write prescriptions for themselves and Family? | allnurses

Can NPS write prescriptions for themselves and Family?

  1. 0 I know some states don't give prescription writing authority to NPs, but in the states that do, I was wondering if NPs can write their own prescriptions and order their own blood tests?
    I don't mean for controlled substances, like morphine or something-
    But, I have a thyroid condition and I was wondering if someday- when I'm an NP- I will have the ability to order my own TSH tests and write my own prescription for Armour?
    I always have to rely on the whim of whatever doc I have to order the tests I want done. It took forever for me to get the dx of hypothyroidism. It would be nice to have the ability to order what I want done.
  2. Visit  traumaRUs profile page
    1
    I wouldn't want to be prescribing for myself and/or family members. Not ethical and not legal in IL. It is a conflict of interest. In IL, you must have an established provider/pt relationship and they will discipline you if caught writing scripts in other situations.
    CaNP likes this.
  3. Visit  sirI profile page
    1
    All states now have prescription privileges.

    traumaRUs is correct, however, in that the APN self-prescribing is something where one needs to be careful and know his/her NPA.

    Here is a thread about this very topic:

    http://allnurses.com/forums/f34/can-...ves-68427.html

    Even if it is not expressly illegal under many state laws to prescribe a controlled substance for a family member, it is always inadvisable. If a pharmacist receives a prescription for a controlled substance for a patient with the same last name as the prescriber, the pharmacist may suspect that the prescriber is using the drug himself or herself and may report that nurse practitioner to the licensing board, which may investigate. The NP may find himself or herself in the position of having to prove that he or she is not self-administering controlled substances. Furthermore, Drug Enforcement Administration (DEA) numbers are specific to a practice setting, so an NP who prescribes a controlled substance for a family member who does not come to the practice setting may be violating 2 laws.
    celclt likes this.
  4. Visit  diapason05 profile page
    0
    So.. I couldnt even prescribe thyroid hormone for myself?? That's kind of silly. I'm sure my provider would work with me though to order the tests I want and prescribe what I want for my thyroid. It's been so crappy trying to regulate my dosage. Some doctors have been dosing according to my symtoms, others only do it according to TSH. TSH is bunk, I believe.
    Last edit by sirI on Oct 12, '07 : Reason: TOS
  5. Visit  sirI profile page
    1
    Silly or not, if it is in your NPA that you cannot do so, then it is law.
    celclt likes this.
  6. Visit  core0 profile page
    4
    Quote from diapason05
    So.. I couldnt even prescribe thyroid hormone for myself?? That's kind of silly. I'm sure my provider would work with me though to order the tests I want and prescribe what I want for my thyroid. It's been so crappy trying to regulate my dosage. Some doctors have been dosing according to my symtoms, others only do it according to TSH. TSH is bunk, I believe.
    Symptoms are the part that is bunk. If I had a dollar for every patient who came in and told me I'm tired/gained weight etc. my thyroid is off, I would be very rich. The way to regulate thyroid is by normalizing the TSH.

    As far as prescribing for yourself there is an old saying in law. Someone who serves as their own lawyer has a fool for a client.

    David Carpenter, PA-C
    BmoreCRNP, dansingrn, kanzi monkey, and 1 other like this.
  7. Visit  sirI profile page
    0
    Please do not debate personal medical issues. Please keep to the topic:

    Can NPS write prescriptions for themselves and Family?

    Thank you.
  8. Visit  PMFB-RN profile page
    0
    Certainly NPs can write for their family members (at least in Wisconsin). This is exactly as it should be and I would view any attempt to change this as discrimination against those living in rural areas.
    I live in a very small town (pop. 505) in a very rural area. We have one NP staffed primary care clinic. If that NP could not write rx for her family members they would have to travel 74 mils one way to the next care provider, assuming they could get an appointment. I would assume that the family members would come to the clinic and be seen just like any other patient.
    Self prescribing would be another matter however.
  9. Visit  sirI profile page
    1
    Quote from PMFB-RN
    Certainly NPs can write for their family members (at least in Wisconsin). This is exactly as it should be and I would view any attempt to change this as discrimination against those living in rural areas.
    I live in a very small town (pop. 505) in a very rural area. We have one NP staffed primary care clinic. If that NP could not write rx for her family members they would have to travel 74 mils one way to the next care provider, assuming they could get an appointment. I would assume that the family members would come to the clinic and be seen just like any other patient.
    Self prescribing would be another matter however.
    I for one, am not absolutely saying it's not done. But, as you pointed out, this is what is done in your state. And, the individual family member must have a healthcare provider to patient relationship; not blindly prescribing without examination.

    Prescription without proper examination and diagnosis=malpractice

    Again, one would have to ensure their individual state NPA allows this.

    And, I totally agree with you about self-prescribing.
    ruralnurs likes this.
  10. Visit  PMFB-RN profile page
    0
    I for one, am not absolutely saying it's not done. But, as you pointed out, this is what is done in your state. And, the individual family member must have a healthcare provider to patient relationship; not blindly prescribing without examination.

    *** Of course. As I said I would assume the family member would come to the clinic and be seen just like any other patient . In the particular case I am friends with the NPs husband. I know of one time he stepped on a nail and drove it right through his foot while wearing manure covered rubber barn boots. He went to the clinic (I drove him) where his wife examined him, had X-rays done and he left with a RX for vicodin and an antibiotic. Why should this farmer have to drive 74 miles to receive basic care because he happens to be married to a NP who is the care provider in our town?

    Prescription without proper examination and diagnosis=malpractice

    *** Of course, but that's not what I was talking about.

    Again, one would have to ensure their individual state NPA allows this.

    *** Very true, however in those states that don't the NPA should be changed and if I lived in such a state I would work for such change.
  11. Visit  sirI profile page
    0
    Thank you for your input.

    Good debate.
  12. Visit  JALEXSHOE profile page
    0
    Honestly, I think the issue you debate is clarified by the fact that there was a patient/provider relationship with an actual chart, assessment, testing, and treatment plan documented.

    In Florida, even physicians are held to the standard that they must have the above on patient's to show a traceable pattern of care to substantiate the prescription.

    It has always been frowned upon to treat family members surely as far back as I can remember. But I think this was instituted more as a means of ethics and personal conflict than as a means to restrict care. I am sure in a case such as "Wisconsin" states, that the criteria was met and the treatment was appropriate in that case.

    The issue would seem to me to be more concern over integrity and professionalism. Personally, I would pass the care to another provider I worked with, if an option, or make sure I documented the reason I was the provider (unavailability, etc) to make sure no claims of malfeasance could be raised. Do I think the person who treated the nail injury wrong...no...not in the case as it was presented.

    The key is to have documentation. If one holds every patient to the same standard of care, treating all the patients in the same manner, with the same forms of documentation, then this is something different than a prescription given due to a friendly phone call and no patient relationship. One needs to understand the rules of their state, practice under the guidelines as they state, and realize that the rules were put there for a reason. Sometimes rules are good things, meant to protect and prevent harm. If they are bad things, then work with legislation to get them changed.

    I cannot think of a reason to ever treat myself, nor would I want too. I over analyze too much and being an old ER nurse, blow off more than I should. I am too close to myself to make a rational, unbiased opinion. I might know exactly what is wrong with me, but I want someone else to tell me what it is, in case I am missing something. Two heads are better than one.
  13. Visit  PMFB-RN profile page
    0
    Assuming that all criteria for a true provider/patient relationship where met and that a provider would only treat a family member when an alternative provider was not available, the laws absolutely need to allow NPs, PAs, MDs, & DOs to treat their own family members. To prevent them doing so is simply discrimination against those who live in rural areas.
    For example how could a provider be induced to take a position in a rural area to serve an undeserved population if it means that their own children would be denied access to health care? Everybody in the area benefits from the providers services but the providers own family members mush travel very long distances for treatment?
    Our little town has a single provider clinic. It is the only one for a long way around. We used to have a great old time country doctor who kept regular office hours plus would come in for emergent situations when called. When he retired this town had no health provider for over a year until a FNP took over the same clinic. Not having a health care provider significantly reduced the quality of life for area residents. I doubt that the NP could have been attracted at all if it meant her family would be the only ones in the area who would be forced by law to travel long distances.

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