Can I - as an RN - recommned OTC drugs?

[mischaj718]

hello all,

so i have a question for all you lovely nurses. i tried to find the answer in the nurse practice act, but can't seem to find it (then again, maybe i'm not looking in the right spot).

being a fairly new nurse, i am wary of what i can and cannot do (what my scope is). i am even wary to recommend otc drugs. then the nurse that i was training with was telling me that if a patient calls in with chest pain, you can recommend that they try maalox to see if that helps, while you inform the md (i work in ambulatory nursing, but my title is not advice nurse, but, sometimes pts call with sx, so i do a little bit of "triage" - if you will.). i am honestly scared to advise them to take otc's because what if they have some condition that contradicts maalox etc.....i asked the other rn's and they said "yes, you can recommend otc's". so, i accepted this as true.

then, today, i was perusing the brn website with the disciplinary actions and came across one where a nurse was disciplined for giving (pt who was c/o chest pain) maalox without an md order to a pt. (however, i believe the more relevant reason for the discipline was that he sent the pt back home telling him to wait for the md in the morning). however, on the list of things he was being disciplined for was "respondent's administration of maalox without a physician's order exceeded the respondent's score of practice".

so, i beg the question: can rn's advise/recommend otc's to pts? i worked so hard for this license, i will be struck dead before i lose it to something dumb.........

thanks in advance!!!!! :d

[diane227, LPN, RN]

In most places where I have worked we have avoided giving advice over the phone because you cannot see the patient and assess them for yourself so you don't really have a way of knowing what you are dealing with. The only time that I give any phone advice is when the patient has just been discharged and calls me back with a question within a 24 hour period. Otherwise I refer them to the ED or to their doctor. But even then, it depends on what they are asking me. In some places they have criteria for giving phone advice and you will have to determine if your facility has something like that in place. If they do not, I would avoid giving any advice over the phone if it involves a medical condition and the person is requesting an opinion or treatment. The risk is just too high. I absolutely would NEVER EVER tell anyone to take maalox for any type of abdominal pain or chest pain ever. Any person with a call like that would get referred to call 911 or go to the ED immediately. When my mother had cancer, the cancer hospital where she was treated had standard protocols to deal with patient phone calls for care. They would advise you and they documented the call for placement into the patients medical record. This was the only facility that I have ever seen this system work.

[BlessedMomRN]

"being a fairly new nurse, i am wary of what i can and cannot do (what my scope is). i am even wary to recommend otc drugs. then the nurse that i was training with was telling me that if a patient calls in with chest pain, you can recommend that they try maalox to see if that helps, while you inform the md"

if i had a patient call in with chest pain i would recommend taking an aspirin if they are not allergic and call 9-1-1-. i suggest never telling someone to take maalox and wait for a doctor's call if they use the words "chest pain."

[BluegrassRN]

If you work in a physician's office or an outpt clinic, they should have some sort of triage protocols for you to use.

If they don't, here's a great book that your office can buy and, pending physician approval, use for the nurses who do phone triage.

http://www.amazon.com/Tele-Nurse-Telephone-Protocols-Sandi-Lafferty/dp/0766820475/ref=sr_1_1?ie=UTF8&s=books&qid=1267717911&sr=1-1

I used to work in a physician's office, and I received this book with a 30 hour CEU. We took the 20 most common phone complaints, and used the book to work up our own little quick reference cards for nurses to use. We based it off of the book's triage recommendations, our practitioners added some questions they wanted answered and their OTC/herbal/nutritional recommendations. It was really nice to have, it protected the nurses, helped the docs (fewer phone calls for them) and standardized our responses.