Rx Writing Liberties

Specialties NP

Published

There is this certain doctor at the nursing home and when he comes around it's like the pied piper--everyone (employees and family members, too) is following this doc around describing ailments and such. A lot of times he will whip out his pad and say a round of Ceclor should help that or there is this new drug called xoxox for bladder control problems and write them a prescription.

I don't condone this and I've never tried to get freebies like that, but do you get people who think you're a walking "free" medical clinic and can just write a prescription for them or their relatives for the asking? I think I would kind of resent that. What do you tell people when (and if) they try to bum free prescriptions off you?

P.S. Wish I had made the title something else, like "Rx Bums."

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Per our NPA and guidelines set forth when we receive DEA in order to write prescriptions, we cannot write prescriptions unless we enter into a provider-patient relationship.

Any APN who would blatantly hand out prescriptions like the above is practicing beyond their scope and stands to lose not only prescription privileges, but license as well.

I have no problem telling anyone, "I'm sorry, but you need to see your healthcare provider".

Period.

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For me, it really depends. If I know the pt well (and it is an established pt) I can write something. I have a little notebook where I write down the pt's name and what I did so that I can get to the chart and make a note. This is a major liability issue otherwise.

If I'm rounding with my MD and we are on call I will do some mental triage and act accordingly.

I am not comfortable whipping out the verbal orders, even knowing that someone will come along and ask me to sign off in the future.

I have had friends who have asked for Rx for stuff... like viagra or bactrim (no narcs or anything). If they are of the practice I'm with I may or may not write something, then make a note and then go to the chart later. Otherwise they are okay with me saying they have to make an appt.

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Specializes in LTC, MDS, Education.

HEY GOLYTELY I just had a thought. In another post you were concerned about that CNA trying to score meds? Well, maybe your "pied piper" doctor had written her some scripts and then stopped? So the plot thickens. Just a thought......:smilecoffeecup:

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Specializes in Nephrology, Cardiology, ER, ICU.

I work in the outpatient setting for the most part and in the beginning, had several people test the waters requesting scripts from me. Never went there and glad I didn't!

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There is this certain doctor at the nursing home and when he comes around it's like the pied piper--everyone (employees and family members, too) is following this doc around describing ailments and such. A lot of times he will whip out his pad and say a round of Ceclor should help that or there is this new drug called xoxox for bladder control problems and write them a prescription.

I don't condone this and I've never tried to get freebies like that, but do you get people who think you're a walking "free" medical clinic and can just write a prescription for them or their relatives for the asking? I think I would kind of resent that. What do you tell people when (and if) they try to bum free prescriptions off you?

P.S. Wish I had made the title something else, like "Rx Bums."

The TX Board of Medicine and Board of Nursing is very strict about this. We can't write scripts for patients unless we see them as a patient - a H&P has to be in the chart with diagnosis, plan, etc. You should read press releases on the Board of Medicine concerning this. Doctors are getting nailed for calling out scripts without seeing the patient. It is also against the rules to treat immediate family members. I know a doctor who was disciplined b/c she wrote a script for Paxil for her son. I'm not sure why they make such a big deal out of it, but docs are getting busted all the time. Is it like that in other parts of the country?

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

Hi ANPFNPGNP (boy you have been busy). About not writing for family. I was told in my program that this is not illegal, but frowned upon. I worked with a psychiatrist that wrote abx for friends and family and neurontin for herself for menopause.

Anyway is there someplace I can find that shows it is illegal because I have a crazy sister that has been asking me for scripts ( have not done it). Is this state dependent?

It does surprise me how many people will ask for scripts, not even for narcs as was mentioned just for whatever.

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I was told in my program that this is not illegal, but frowned upon. I worked with a psychiatrist that wrote abx for friends and family and neurontin for herself for menopause.

It's not "illegal," but more than frowned upon in Texas. It's against the rules for doctors, PA's & NP's (NP's practice under the Board of Nursing). I'm sure it's probably different in every state.

The public can look on the TX BOM website and read their press releases, which are updated every 3 months after the Board meets. Almost every time they meet, they discipline a doctor b/c they wrote scripts without seeing the patient or they were caught writing scripts for immediate family members. They are usually fined $500-$1,000 and have to complete a certain number of CEU's. I've never been able to find this type of information pertaining to NP's, b/c it's not on the BON website.

Something else that's come up in TX. Many docs are selling nutritional supplements to patients that aren't FDA approved. I remember reading about a doctor who got into a lot of trouble for that. Apparently, the docs can recommend supplements, but they aren't supposed to be selling them for a profit, since they aren't FDA approved. I see this done all the time, but the Board of Texas has deemed this unethical...which it is.

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