Quote from mammac5
Waiver: (Tongue in cheek) I realize that no one here is qualified to give me actual legal advice. I will not hold anyone here responsible for any advice I may be given. If I make a stupid decision based on stupid advice, I pledge to hold the poster as harmless.
So here's the deal. I work inpatient on a diabetes research study. The NPs and PA manage the diabetes treatment for patients admitted (usually NOT for diabetes) who sign a consent to participate in the study. We do not see the patients for follow up after hospital discharge. Part of the study includes certified nurse educators who contact the patients one week after discharge to ask scripted questions such as confirming the doses of insulins or other meds the patient was prescribed at DC, has the patient had hypoglycemia since DC, has the patient had hyperglycemia since DC, has the patient required ER treatment since DC, etc.
In the past, the NPs and PA were asked to help out with these phone calls, which I tried to do. I quickly realized this put me in a tight spot when a patient had very low or very high glucose at home...I was supposed to just gather data and not advise or treat the patient whatsoever. After that experience I refused to do further follow up calls and explained to the group my thoughts that I am responsible to evaluate and treat patients to the highest level of my license and education, so hearing a patient tell me he has blood sugars of 300+ at home obligates me to at least instruct the patient in adjusting his insulin doses OR to prescribe an additional medication for better control.
Am I right? The question of our doing these phone calls is going to come up in a meeting in the near future and I want to be prepared. I emailed the service department at my liability insurance carrier to ask the question and have not yet received a response.
Are there not safety parameters for these follow up calls? Like, if blood sugars reported <60 or symptoms of hypoglycemia, or sugars >400 call so-and-so doctor or seek emergency treatment? Anyone making the calls could follow these instructions (though "symptoms" may be more nuanced for a non-medical professional).
Also, are you identifying yourself as an NP when you make these calls? Do the patients understand that when they report this information over the phone that they are not going to receive advice or intervention even if they need it?
As far as prescribing an intervention over the phone--that sounds dubious as you are not acting as their care provider and may not know the patient well enough. But if they're having an issue, they should be instructed to seek treatment asap (then be followed up on by their doc).
As far as overhearing a blood sugar report while waiting in line--whatever, ignore it. But if someone actually checks their blood sugar in my vicinity and it's, say, 40, I'd help them out. Mind you, this never happens in Walmart lines