Unlicensed personnel calling in prescriptions?!

Nurses Safety

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My sister is a nurse in Indiana and the story she related to me makes me mad. Is this legal?

I know I have seen posts about secretaries and others triaging phone calls but I haven't heard anyone say they also call in prescriptions.

My sister had an encounter this week regarding a presciption for her daughter. She received a phone call informing her that the physician's office was calling in a script for antibiotics for her daughter (after a urine culture). She asked what her daughter was being treated for and what the antibiotic was and was told "a UTI and the antibiotic is microbid". (The med was obviously Macrobid). She said she wanted to know what the organism is they were treating and at first the person said she didn't know, then came back with nitrosomething. My sister said she had never heard of such an organism and asked to speak to a nurse. She didn't get one. This is the person who called in the prescription! My niece said she didn't know what the big deal was. She works afterschool in a doctors office and calls in presciptions all the time! Is this legal in Indiana?

Also, my niece had surgery recently and my sister found out the person doing the prescreening on the phone was not a nurse either! This is not right!

I'm still a nursing student but I'm constantly informing people I know about the healthcare situation. Most of them are totally unaware that they are being treated by people with very little education or training. It isn't just nurses. They are also training people to take x-rays at clinics. They know the procedure but have no formal radiology training. What next?

Okay, I'm done ranting. :confused: I would like to hear if anyone else has heard of unlicensed personnel calling in prescriptions though.

-Roberta

Oh, and I think she meant Zantac instead of xanax!!

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I'm an RN, the very first time I called in a prescription I asked the pharmacist on the other end of the line if they needed my full name and nursing license number. I was FLABBERGASTED when she told me, "You're an RN? We don't need your name, you're better than what we usually get!" She went on to say they get secretaries, medical assistants, etc calling in scripts. I was calling in NARCOTICS!! I couldn't believe it. All I could think was about how easy it would be for me to call in a narc prescription for ANYBODY if I were the type of person to do that!! I hated calling in prescriptions because of this. Didn't feel comfortable with it. Anyhow, the pharmacists here no longer take narc scripts over the phone (Thank goodness!), but you still don't have to be a nurse to call in the others. Still a mistake, I think. Hopefully this will change too!

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I'm not sure how it could be changed...

Only if the pharmacy required an RN/LPN, and then verified her lic# w/ the nursing board the next business day before filling the rx...

Otherwise anyone can say she's a nurse...

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I would put the responsibility on the physician/ facility rather than the pharmacy. (Ideally, it should be a cooperative effort, but in the chain of communication, the safeguards need to start where the presciption initiates.)

If a physician/ facility would require of whatever employee calls in the RX to spell out the name of the drug along with the directions, many problems could be avoided.

1) The physician would have to write or print legibly.

2) The person calling the RX would not risk misreading or mispronouncing a name. (i.e. Zantac would not become Xanax.)

3) Risk of mistakes due to variations in dialects/ accents would be minimized. (May be a regional issue, but definitely can create problems in my neck of the woods!)

When you are concerned about a particular facility's practice, send a certified or registered letter to the physician or administrator expessing your concern. Be polite. Cite specific examples of the reason for your concern, and request a reply by a specific (reasonable) date. Suggest what you think would improve the situation. (Use my suggestions above if you'd like.)

If you do not get a response from the facility, send a second letter, including a copy of your first letter, and CC a copy to your local media. Even if the newspaper or tv station doesn't do anything with the info, the facility may initiate change to avoid the risk of publicity.

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Specializes in CCU (Coronary Care); Clinical Research.

I also work part time at a clinic...the MAs call in RXs all the time, in fact, the clinic does not even have an RN that works there (other than me, and I only do clinical trials and am very part time and trying to leave). The MD has to write the RX and the MA calls it in. We have even had one of the MAs tell patient that DR. so and so would not prescribe them a narcotic due to their symptoms....(which may have been the case but it is not the MA that should decide this...esp since i later showed it to the Dr. and he did rx ty3....)

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Brace yourselves for this one folks. In North Carolina, MAs can do whatever the physican deems appropriate for them to do. They have no to minimal training, no regulatory boards, and frequently don't even have to meet the minimal certification requirements currently in place for CMAs. They can literally walk in off of the street with NO training and function as a medical assistant. In some clinics it is so bad that MAs run rampant without any apparant supervision. My wife worked in a place that tried to assign a MA as the "clinical supervisor" over a LPN and a RN. This is against the law in the State of NC but they wouldn't change the chain of supervision so she quit and reported to facility to the State. This was how the Physicians and Office Administrators in NC dealt with Nurses finally demanding and receiving semi-decent pay. The State BON has made it quit clear that MAs cannot supervise Nurses nor can they over ride a Nurse's authority. The battle still rages...

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Specializes in Everything except surgery.

Calling the wrong med in and calling in RX for themselves isn't just a problem with unlicensed people. Nurses calls the wrong meds in, and call in RX for themselves or others also! I have worked with an excellent MA, and I would trust her, before I would trust some nurses I have worked with!

I feel RXs should be faxed with the MD's signature., and there should be some kind of control system, as to what has been faxed to the pharmacy, so things like this don't happen.

http://www.drl.state.wi.us/Regulation/licensee_services/nursing_board/nur1197.htm

The single most reason I have seen for nursing being disciplined by the board is for drugs.

Yes I do understand the problem, but let's not blame it all on unlicensed personnel calling in those RXs. I think there sholuld be more accountability for everyone in dealing with RXs . Just being the devils advocate here:)

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Specializes in Outpatient/Clinic, ClinDoc.

At my clinic, the MA's call in 99% of the Rx's. They also will call and inform the patient of things the MD's want them to know ("Call Pt, he has anemia"), etc. This is in California. I'm under the impression that in this state MA's are allowed to do whatever the MD lets them do.

RN's do all the screening of pt messages, lab results and walk-ins, however.

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Specializes in Trauma ICU, MICU/SICU.

Would be better to fax in rx's. Oh wait a minute... Doctors write rx's and its hard enough to read them live :rolleyes: A fax would be 10X worse.

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

(i think a fax might make it more legible LMAO)

When i lived in WV i worked in a home setting semi-independent living house where three ladies with mental disabilities lived. We were able to call their prescritions in no matter what the drug was.

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Specializes in Everything except surgery.

Doctors whose handwriting in illegible are responsible for many inaccurate RX being filled. Maybe this should be the norm, instead of the exception, and would make things a lot safer, and easier for everyone concerned. It would also help to decrease the number of fraudulent RX...hopefully.

http://www.ecrm-epps.com/Expose/V6_10/5.pdf

Or at least something like it. I think the price would come down, as it became more widely used. Many hospitals no longer allow an MD to even write orders on a chart. They must enter them into the computer. Especially military, and VA hospitals have been doing this for a number of years.

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Specializes in Critical Care.

I currently work as a med. sec. in an out pt psych clinic. I handle our "med refill" line... ppl leave a msg as to what they need I write it up, pull the chart, and the RN comes to call in the scripts. Docs are the only ones who can do narcotics...

However, I can't tell you how many times a pharmacy has called to request a refill and asked me if I wanted them to go ahead and fill the script. When I say I'm not a nurse they tell me that's okay....SCARRY!!! It amazes me what I could do if I wansn't an ethical person... I could medicate myself out the wazzu!!! Not to mention seriously messing up our already less than stable patients...

It's a shame there isn't some federal regulations regarding who can call in and fill scripts. Perhaps when some congressman gets the wrong thing and dies b/c a secretary called in his med things will change.

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