Can NPS write prescriptions for themselves and Family?

Trauma Columnist · Oct 12, 2007

I wouldn't want to be prescribing for myself and/or family members. Not ethical and not legal in IL. It is a conflict of interest. In IL, you must have an established provider/pt relationship and they will discipline you if caught writing scripts in other situations.

Editorial Team / Admin · Oct 12, 2007

All states now have prescription privileges.

traumaRUs is correct, however, in that the APN self-prescribing is something where one needs to be careful and know his/her NPA.

Here is a thread about this very topic:

https://allnurses.com/forums/f34/can-nps-prescribe-family-members-themselves-68427.html

Even if it is not expressly illegal under many state laws to prescribe a controlled substance for a family member, it is always inadvisable. If a pharmacist receives a prescription for a controlled substance for a patient with the same last name as the prescriber, the pharmacist may suspect that the prescriber is using the drug himself or herself and may report that nurse practitioner to the licensing board, which may investigate. The NP may find himself or herself in the position of having to prove that he or she is not self-administering controlled substances. Furthermore, Drug Enforcement Administration (DEA) numbers are specific to a practice setting, so an NP who prescribes a controlled substance for a family member who does not come to the practice setting may be violating 2 laws.

diapason05 · Oct 12, 2007

So.. I couldnt even prescribe thyroid hormone for myself?? That's kind of silly. I'm sure my provider would work with me though to order the tests I want and prescribe what I want for my thyroid. It's been so crappy trying to regulate my dosage. Some doctors have been dosing according to my symtoms, others only do it according to TSH. TSH is bunk, I believe.

Editorial Team / Admin · Oct 12, 2007

Silly or not, if it is in your NPA that you cannot do so, then it is law.

core0 · Oct 12, 2007

So.. I couldnt even prescribe thyroid hormone for myself?? That's kind of silly. I'm sure my provider would work with me though to order the tests I want and prescribe what I want for my thyroid. It's been so crappy trying to regulate my dosage. Some doctors have been dosing according to my symtoms, others only do it according to TSH. TSH is bunk, I believe.

Symptoms are the part that is bunk. If I had a dollar for every patient who came in and told me I'm tired/gained weight etc. my thyroid is off, I would be very rich. The way to regulate thyroid is by normalizing the TSH.

As far as prescribing for yourself there is an old saying in law. Someone who serves as their own lawyer has a fool for a client.

David Carpenter, PA-C

Editorial Team / Admin · Oct 13, 2007

Please do not debate personal medical issues. Please keep to the topic:

Can NPS write prescriptions for themselves and Family?

Thank you.

PMFB-RN, RN · Oct 13, 2007

Certainly NPs can write for their family members (at least in Wisconsin). This is exactly as it should be and I would view any attempt to change this as discrimination against those living in rural areas.

I live in a very small town (pop. 505) in a very rural area. We have one NP staffed primary care clinic. If that NP could not write rx for her family members they would have to travel 74 mils one way to the next care provider, assuming they could get an appointment. I would assume that the family members would come to the clinic and be seen just like any other patient.

Self prescribing would be another matter however.

Editorial Team / Admin · Oct 13, 2007

Certainly NPs can write for their family members (at least in Wisconsin). This is exactly as it should be and I would view any attempt to change this as discrimination against those living in rural areas.
I live in a very small town (pop. 505) in a very rural area. We have one NP staffed primary care clinic. If that NP could not write rx for her family members they would have to travel 74 mils one way to the next care provider, assuming they could get an appointment. I would assume that the family members would come to the clinic and be seen just like any other patient.
Self prescribing would be another matter however.

I for one, am not absolutely saying it's not done. But, as you pointed out, this is what is done in your state. And, the individual family member must have a healthcare provider to patient relationship; not blindly prescribing without examination.

Prescription without proper examination and diagnosis=malpractice

Again, one would have to ensure their individual state NPA allows this.

And, I totally agree with you about self-prescribing.

PMFB-RN, RN · Oct 13, 2007

I for one, am not absolutely saying it's not done. But, as you pointed out, this is what is done in your state. And, the individual family member must have a healthcare provider to patient relationship; not blindly prescribing without examination.

*** Of course. As I said I would assume the family member would come to the clinic and be seen just like any other patient . In the particular case I am friends with the NPs husband. I know of one time he stepped on a nail and drove it right through his foot while wearing manure covered rubber barn boots. He went to the clinic (I drove him) where his wife examined him, had X-rays done and he left with a RX for vicodin and an antibiotic. Why should this farmer have to drive 74 miles to receive basic care because he happens to be married to a NP who is the care provider in our town?

Prescription without proper examination and diagnosis=malpractice

*** Of course, but that's not what I was talking about.

Again, one would have to ensure their individual state NPA allows this.

*** Very true, however in those states that don't the NPA should be changed and if I lived in such a state I would work for such change.

Editorial Team / Admin · Oct 13, 2007

Thank you for your input.

Good debate.

JALEXSHOE · Oct 15, 2007

Honestly, I think the issue you debate is clarified by the fact that there was a patient/provider relationship with an actual chart, assessment, testing, and treatment plan documented.

In Florida, even physicians are held to the standard that they must have the above on patient's to show a traceable pattern of care to substantiate the prescription.

It has always been frowned upon to treat family members surely as far back as I can remember. But I think this was instituted more as a means of ethics and personal conflict than as a means to restrict care. I am sure in a case such as "Wisconsin" states, that the criteria was met and the treatment was appropriate in that case.

The issue would seem to me to be more concern over integrity and professionalism. Personally, I would pass the care to another provider I worked with, if an option, or make sure I documented the reason I was the provider (unavailability, etc) to make sure no claims of malfeasance could be raised. Do I think the person who treated the nail injury wrong...no...not in the case as it was presented.

The key is to have documentation. If one holds every patient to the same standard of care, treating all the patients in the same manner, with the same forms of documentation, then this is something different than a prescription given due to a friendly phone call and no patient relationship. One needs to understand the rules of their state, practice under the guidelines as they state, and realize that the rules were put there for a reason. Sometimes rules are good things, meant to protect and prevent harm. If they are bad things, then work with legislation to get them changed.

I cannot think of a reason to ever treat myself, nor would I want too. I over analyze too much and being an old ER nurse, blow off more than I should. I am too close to myself to make a rational, unbiased opinion. I might know exactly what is wrong with me, but I want someone else to tell me what it is, in case I am missing something. Two heads are better than one.