Verbal Orders from NP/PA

Specialties NP

Published

Specializes in ICU, CVICU.

Hey all,

I have a random question about prescribing by PAs and NPs. Can NPs/PAs prescribe over the phone (in other words, can I take a verbal order from a PA/NP)? If so, do the same rules apply (they have to co-sign within a certain time frame)

Thanks,

Linda

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Hey all,

I have a random question about prescribing by PAs and NPs. Can NPs/PAs prescribe over the phone (in other words, can I take a verbal order from a PA/NP)? If so, do the same rules apply (they have to co-sign within a certain time frame)

Thanks,

Linda

The general answer is yes. If the NP/PA has prescriptive authority in the state (which is most if not all states) then they can call in verbal orders. I am assuming that you are referring to hospital orders?

If that is so then the long answer depends on your hospital bylaws. I am not aware of any state law that prevents PAs or NPs from calling in phone orders. Hospital bylaws may limit who can call in phone orders. They will also tell you who has to cosign and in what time frame. Depending on the state there also may be time limits to sign the order. In addition many hospitals require the PA/NP order to be signed by the person who gave it but also cosigned by a physician. Of course if any provider (PA/NP/Physician) does not have privileges then they cannot phone in an order.

So short answer

David Carpenter, PA-C

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The general answer is yes. If the NP/PA has prescriptive authority in the state (which is most if not all states) then they can call in verbal orders. I am assuming that you are referring to hospital orders?

If that is so then the long answer depends on your hospital bylaws. I am not aware of any state law that prevents PAs or NPs from calling in phone orders. Hospital bylaws may limit who can call in phone orders. They will also tell you who has to cosign and in what time frame. Depending on the state there also may be time limits to sign the order. In addition many hospitals require the PA/NP order to be signed by the person who gave it but also cosigned by a physician. Of course if any provider (PA/NP/Physician) does not have privileges then they cannot phone in an order.

So short answer

David Carpenter, PA-C

I am a senior RN student but have yet to begin our legal/ethics class and was wondering if a nurse could get into trouble for giving a drug presribed by a NP/PA if said practioner was not legally allowd to prescribe that drug. I always just assumed that PA/NP was functioning in a role as a provider and the nurse -PA/NP relationship would be the same as nurse-MD/DO but there are always questions about the legalities of taking orders, prescriptions etc... from NP/PA that I guess I am wondering if as a nurse you need to read the state laws of practice for all of the practitioners so that you know what is legal or not. (why can't they just all be the same from state to state! lol). I know hospital policy is involved but just wondered how all of these differences affect the nurses.

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Specializes in ICU, CVICU.
The general answer is yes. If the NP/PA has prescriptive authority in the state (which is most if not all states) then they can call in verbal orders.

Thanks David! That was really helpful :)

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Specializes in Nephrology, Cardiology, ER, ICU.

I work in a large nephrology practice and physically work in two hemodialysis units. When my patients need to be admitted to the hospital from the unit, I do sometimes have to give verbal orders. I am credentialled at the three local hospitals. However, my doctors are the ones that co-sign my orders because I don't physically go there.

However, I would never call an order to a hospital where I'm not credentialled. So, if you as an RN took a verbal order in good faith that I was credentialled, the fault would lie with me.

BTW, when you take verbal orders, ask for the spelling of the last name of the provider. I have a very unusual last name and I always wonder how it gets spelled. I automatically spell it out.

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Specializes in ICU, CVICU.

BTW, when you take verbal orders, ask for the spelling of the last name of the provider. I have a very unusual last name and I always wonder how it gets spelled. I automatically spell it out.

Thanks! That is also great advice.

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Specializes in Nephrology, Cardiology, ER, ICU.

You're welcome. It also makes it easier for my doctors who then must co-sign my order.

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