Is it possible (legal) for a student nurse to administer medication without supervision of the preceptor nurse or the clinical instructor?
I know it happens all the time, and often if the student makes a mistake, she is severely penalized.
I am wondering whether it is possible for the hospital, preceptor nurse or clinical instructor to allow the student nurse to administer medication without providing supervision through every step of the way.
I was told by someone that it is illegal (against Nurse Practice Act in most states) for a student to administer medication even if it is P.O., and that an RN must be with the student through every step of the process.
Is this true? Is this law different from state to state? Or is this pretty much the same in all states?
I see the concern for sure! I guess it just depends on the hospitals/programs because in the same hospital after I had given birth the student nurse didn't get to do anything but watch. (These were two different schools in the area)
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
Whether it was legal or not, no way I would administer anything without my instructor present. If anything needed to be given that stat, the co-assigned nurse would give it, otherwise we wait for our clinical instructor to accompany each student. In this day and age, there's no point in putting yourself in *any* questionable situation, I think.
In my school and hospital I went for clinicals, my instructor had to check my meds before I went into room and administer them. I don't even remember my CI's being in the room with me when I was adm meds to patients, except for in 1st and some of 2nd semester. But I always asked the CI and my preceptor nurse if I could go ahead and adm them or if they'd like to see me adm meds. They always told me to go ahead and administer them after they checked meds.
When as I was a student, we either had our CI or RN Preceptor check our meds and sign.. No exceptions. Ever.
On the flip side of this, I've precepted nursing students. You can be darn sure I check and double check everything students do, especially since they are technically practicing under my RN license. I worked too hard for my license to do it any other way.
Specializes in Emergency Dept. Trauma. Pediatrics.
They can give meds under the direct supervision on an RN (instructor or staff), who must co-sign the medication administration record.
Oh ok, I was confused on the bolded statement. That is the same way it is in one of our hospital systems. The MAR will come up for a co-signature when scanning and submitting. Another hospital system doesn't have the Co-Sign, it's charted under the Co-Nurse but they require someone to be there as well.
Oh ok, I was confused on the bolded statement. That is the same way it is in one of our hospital systems. The MAR will come up for a co-signature when scanning and submitting. Another hospital system doesn't have the Co-Sign, it's charted under the Co-Nurse but they require someone to be there as well.
OK. I see where the confusion came in. I was trying to emphasize that the RN has to be actually at the bedside and directly supervising the med administration. The RN can't take the med out of the Pyxis, give it to the student and then let the student go into the room by herself to give it.
I'm sorry I didn't make that clear. Thanks for asking to avoid confusing.
If it's a drug that we've never given before, our instructor goes with us. After that, we can go by ourselves, but we'd still have to cite those every time.
We can get PO meds from the Pyxis, but before administering, we have to show the meds to the clinical instructor, and also give pertinent info if the med requires it (e.g. a HR and BP for a beta-blocker). All clinical instructors I've had after 2nd semester have allowed me to take the meds into the room and give them to the patient after the instructor checked them. I can pull an IV drug from Pyxis, but the instructor is present at bedside when I hang or push it. I can't think of many exceptions to that. Instructors or RNs have to co-sign in the charting software, but no co-sign is needed for us to take the meds out of Pyxis.
What I get uncertain about is when "my" patient needs a med and the RN who is not my clinical instructor asks me to give it. I've refused to do that before on a few PRNs when my instructor was busy with other students -- I feel like if I'm practicing under my instructor's license, I shouldn't do ANYTHING without checking with her.
Similar situation if something about a patient is making me uneasy -- reporting it to an RN on the floor doesn't feel like "enough" to me -- I am always certain to tell my instructor, no matter what. Sometimes I feel stupid for telling the RN and then telling my instructor again in front of her, but...oh well. :)
The hospital I have been at for the last couple of clinicals has computers in each room and the med, patient and nurse must all be scanned for each med. In the case of the student nurse, that means scan med, scan patient, scan instructor, scan student. So, the CI has to be in the room in order for a med to be passed.
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kaylen26
36 Posts
I see the concern for sure! I guess it just depends on the hospitals/programs because in the same hospital after I had given birth the student nurse didn't get to do anything but watch. (These were two different schools in the area)