I work in an outpatient psych clinic. We are a specialty clinic within a larger primary care clinic. I was asked by one of the MDs I work with to tell a new patient via telephone (all of our patient contact is via telephone except for in person MD visits) that at the initial new patient MD visit, the MD will not prescribe a controlled substance. In MDs review of the chart, this patient has a long standing addiction problem which is the reason why MD will not prescribe said medication. I also was told to tell the patient that patient can be prescribed other medications and be treated for other conditions. I went ahead and did it, patient not happy of course.
Yet ethically, morally, I really don't think an RN should be doing this over the phone. This is a conversation to be done in person, face to face, by the MD. The MD should work with the patient in person, by offering to help the patient either go thorough detox or be treated with other non-addicting medications.
Afterwards, I brought it to the attention of our doctors. The MDs reasonings were that it's a safety concern, and that no matter who is telling the patient this, a RN, MA, the secretary, MD, it's not going to be a pretty sight. But I disagree. I nor the MD have any relationship with this patient. It was strictly chart review and no face to face conversation was had before coming to this decision. Im sure this patient has been told 1,000 times No, but who has actually sat down with her and worked through her addiction? I am just a RN, but the MD has more power to work with this patient. In this age of addiction, I think we need to work with these patients to help them, give them options, instead of just doing a blind judgmental no. Thoughts?
Oct 14, '17
Quote from pa715
In MDs review of the chart, this patient has a long standing addiction problem which is the reason why MD will not prescribe said medication.
I require more information before I can give you my thoughts. I'm a little confused:
A Patient may have a chronic problem which necessitates the need for long term controlled substance in which they may be addicted.
Or, the Patient has misused the controlled substance in the past which would be called substance abuse.
But I don't understand "long standing addiction problem".
Please enlighten me.