Can NP's self prescribe?

Specialties NP

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I was wondering if anyone knows or has prescribed themselves anything? Are there any laws that prohibit this or is it simply an ethical dilemma? Does it vary from State to State? Im thinking meds, vaccines and labs/xrays etc. Thanks in advance.

Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

My wife doesn't understand why I refuse to write her scripts or her family. I may make an rare exception for her family as we are not close and I would do a full exam beforehand.

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Specializes in FNP, ONP.

I have self prescribed. My epi pen fell out of my coat pocket into the lake while I was on a fly fishing trip. I wasn't about to go sit in an urgent care for an hour and pay out of network to be seen just to get a new epi pen Rx. I wrote my own. It was not an issue. I have written for my kids in similar circumstances: one kid needed a second albuterol inhaler while we were traveling, another needed a med on Christmas Eve night. I was the person on-call for the practice (my kid sees someone else in my office), and would not even consider bothering a colleague on Christmas Eve night for a simple issue I could easily handle. Nor would I be too pleased if they bothered me for the same! Any other Saturday night or something, sure, but not a holiday like that.

A few weeks ago a colleague woke me up in the middle of a night that I was not on call because her husband had broken out in shingles that night. She wanted me to call in a script for acyclovir so she wouldn't have to do it. Of course I did, but I did think it was dumb and I would have done it myself rather than wake up a friend at 2:00am.

That said, under normal circumstances, I wouldn't do it, and I would never, ever, write anyone a controlled substance without an office visit, no matter who they were.

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Specializes in Nephrology, Cardiology, ER, ICU.

Very very poor practice:

ActionDiscipline. Start Date Discipline. End DateReason For Action

Reprimand 09/22/2009issued prescriptions to one of her family members without proper authorization from her supervising physician.

Fine 09/22/2009issued prescriptions to one of her family members without proper authorization from her supervising physician.

This will unfortunately follow this provider forever...and yes, it was for antibiotics for one of her children while on vacation....

And to put out on the internet that you have self-prescribed.....IP addresses are easily traced.

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Very very poor practice:

ActionDiscipline. Start Date Discipline. End DateReason For Action

Reprimand 09/22/2009issued prescriptions to one of her family members without proper authorization from her supervising physician.

Fine 09/22/2009issued prescriptions to one of her family members without proper authorization from her supervising physician.

This will unfortunately follow this provider forever...and yes, it was for antibiotics for one of her children while on vacation....

And to put out on the internet that you have self-prescribed.....IP addresses are easily traced.

This reprimand is not for prescribing to family...its for prescribing without physician authorization to a family member. In a independent practice state this would not occur.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

I'll have to agree with SlyFox on this. Sounds like a state-specific regulation specifically targeted to NP's and not physicians which is a terribly biased law if you ask me. The AMA itself does not condone the practice of self-prescribing or prescribing for family and friends but realizes there are unusual situations when one has to do it (such as BlueDevil's example).

And on a separate note, NP's don't have to ask collaborating physicians permission to write prescriptions each time in most states so I wonder how this even got brought up.

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I think traumaRUs is talking about a PA he/she had mentioned before in this thread.... Not an NP... and in that case that would explain the reprimand and fine for prescribing to a family member without authorization from a physician....and that is horrible to have on record because most physicians would think twice before hiring this PA.

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I'll have to agree with SlyFox on this. Sounds like a state-specific regulation specifically targeted to NP's and not physicians which is a terribly biased law if you ask me. The AMA itself does not condone the practice of self-prescribing or prescribing for family and friends but realizes there are unusual situations when one has to do it (such as BlueDevil's example).

And on a separate note, NP's don't have to ask collaborating physicians permission to write prescriptions each time in most states so I wonder how this even got brought up.

My guess is that in this state, a practice agreement must be drawn up between the NP and their supervising physician (aka: more restrictive state). For normal prescriptions involving patients of the clinic, the NP can write the prescriptions without permission because it is covered by the practice agreement. In this case, the NP must have written for a family member who did not come to the clinic, thus was not covered by the physician practice agreement. Hence, an NP writing a prescription in this case is doing so without the permission of a supervising physician. Total BS, but chances are they wanted to bust the NP for prescribing to family, but since there is no outright law preventing that, they used this "loophole" instead. Again, this is why if you DO have to prescribe for family, you cover your butt by ensuring you have an established patient record.

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Specializes in Nephrology, Cardiology, ER, ICU.

As I stated this was a PA who I personally know and it was a very sad state of affairs for her.

And here is what I found from the AMA....

Opinion 8.19 - Self-Treatment or Treatment of Immediate Family Members

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
My guess is that in this state, a practice agreement must be drawn up between the NP and their supervising physician (aka: more restrictive state). For normal prescriptions involving patients of the clinic, the NP can write the prescriptions without permission because it is covered by the practice agreement. In this case, the NP must have written for a family member who did not come to the clinic, thus was not covered by the physician practice agreement. Hence, an NP writing a prescription in this case is doing so without the permission of a supervising physician. Total BS, but chances are they wanted to bust the NP for prescribing to family, but since there is no outright law preventing that, they used this "loophole" instead. Again, this is why if you DO have to prescribe for family, you cover your butt by ensuring you have an established patient record.

Listen, while I did agree with your initial comment, you don't have to school me on NP issues. I have been an NP since 2004 and I know how state regulations operate. I've also read the AMA opinion on self prescribing and prescribing for family members. While it is generally frowned upon and discouraged, there are extenuating circumstances when you have to absolutely do it for lack of an alternative option. It is written there in black and white. Controlled substances, on the other hand, are off limits regardless of circumstance. It's an automatic red flag.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
As I stated this was a PA who I personally know and it was a very sad state of affairs for her.

And here is what I found from the AMA....

Opinion 8.19 - Self-Treatment or Treatment of Immediate Family Members

Hey TraumaRUs :)

So does the law in IL only cover PA's then?

I am a big proponent of researching national opinion on the matter (AMA standards as you quoted). However, state laws do vary and it is important for every NP to be aware of how their own practice acts determine how they practice. I would be interested if you enlighten us on how this is written in your practice act. I am sure there are states where NP's specifically are targeted regarding this practice (I do remember a case somewhere in the south regarding a similar provider who happened to be an NP). Self-prescribing and prescribing for family and friends is common with physicians (there are studies that support it) though the AMA discourage it.

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Listen, while I did agree with your initial comment, you don't have to school me on NP issues. I have been an NP since 2004 and I know how state regulations operate. I've also read the AMA opinion on self prescribing and prescribing for family members. While it is generally frowned upon and discouraged, there are extenuating circumstances when you have to absolutely do it for lack of an alternative option. It is written there in black and white. Controlled substances, on the other hand, are off limits regardless of circumstance. It's an automatic red flag.

Juan, I'm very confused as to why you just responded to me in such a hostile manner. In the previous comment, you stated you weren't sure "how it came up" and I was giving you my viewpoint. I don't know if you misunderstood my comment or what, but I don't think having a constructive conversation and putting forth my views on an issue amounts to "schooling you" on NP issues, especially when I thought I was answering a question you just asked in your previous comment.

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Specializes in Adult Internal Medicine.
For normal prescriptions involving patients of the clinic the NP can write the prescriptions without permission because it is covered by the practice agreement. [/quote']

I would venture this was the offending comment.

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