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've read some of the other posts and agree that you should check your state's Nurse Practice Act. I would bet that there is some language in there about the ability of someone to practice nursing, incidental to a nursing education program of study that is approved by the Board of Nursing. There should be school & facility policy about the conditions under which a student can administer medications.
Also, no one ever works under another person's license. However, the responsibility and accountability of nursing care remain with the nurse, meaning that the nurse should always ensure that the individual performing a task has the necessary educational preparation and competence in order to perform the task safely.
By the third semester of my ASN program we could pass po meds and give heparin and lovenox injections and vaccines in the room by ourselves after we told our instructor what we were giving and what each of them were for. In 4th semester we could hang piggybacks and fluids after doing the same and they had to actually watch us do iv pushes and insulin still. Never touched a heparin drip. They acted like heparin drips were large cobras waiting to bite us.
Yeah, same with us on the heparin subqs or vaccine IMs. We can give insulin without RN in room but she has to inspect and sign off on the flexpen after it is dialed or the drawn up insulin (she observes us drawing it up also).
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?
In my state, the RN must be standing at the bedside, but the SN can administer any medication, as long as the RN is there.
The reasons, are numerous:
1. It ensures the medication is being dispensed correctly...even some PO meds need to have vital signs taken prior to administration. This is especially true with IV medications and to ensure compatablity with current IV medications.
2. It ensures the right patient..you don't want a student walking into the wrong room...students do not have this "automatic" check yet b/c it is not yet habit.
3. It ensures the right dose.
4. It ensures allergies are checked on the armband or chart, as appropriate.
That should NOT be happening in your school. It didn't happen in my school...at all. In fact, we were told that if WE did it (even if the RN told us that unofficially, it was ok) and we were caught, that was grounds for dismissal from the program.
So guess what happened? My first clinical rotation passing medications, an RN tried to send me into a room with nitroglycerin and told me it was ok because the "patient had been taking the medication for years"....I refused and said, "Our instructor said, I couldn't".
Yeah, she was mad b/c she had to walk me down there and then mumbled something under her breath about me being "ridiculous" and how all the other students didn't have a problem with it, etc, etc.
Then again, it wasn't her who would lose her job if I did..it would be my butt if I got caught and kicked out of school.
So I didn't give a rat's behind that she was mad.
ASK your instructor what the official policy is and it is YOUR responsibility to follow it.
Specializes in Adult tele, peds psych, peds crit care.
By the third semester of my ASN program we could pass po meds and give heparin and lovenox injections and vaccines in the room by ourselves after we told our instructor what we were giving and what each of them were for. In 4th semester we could hang piggybacks and fluids after doing the same and they had to actually watch us do iv pushes and insulin still. Never touched a heparin drip. They acted like heparin drips were large cobras waiting to bite us.
If you mess up administering an abx drip, it's not terrible... if you mess up a heparin drip, you very well may be looking at a large cobra waiting to bite...
Edited to add that the CI is always present when a student administers meds in our unit... If there are too many students, they only allow "X" number to give meds so the CI can always be present..
In my state, the RN must be standing at the bedside, but the SN can administer any medication, as long as the RN is there.
The reasons, are numerous:
1. It ensures the medication is being dispensed correctly...even some PO meds need to have vital signs taken prior to administration. This is especially true with IV medications and to ensure compatablity with current IV medications.
2. It ensures the right patient..you don't want a student walking into the wrong room...students do not have this "automatic" check yet b/c it is not yet habit.
3. It ensures the right dose.
4. It ensures allergies are checked on the armband or chart, as appropriate.
I imagine it depends on the way that meds are administered at the clinical site. MAK won't let me give meds to the wrong patient in the wrong dose, so long as you don't override the meds or the bracelet, and use JC requirements for patient identification, and overriding would be questioned the next week once the teacher got the override report.
Wow. I can't believe that any student nurse is so capable of administering medications by themselves. Just because "it happens all the time" does not mean that it is okay. Giving medications is serious, and wanting to do it all by yourself is pretty dangerous. When a new nurse is being precepted, sh/he can't give it wothout a preceptor present, and this is for someone who actually has an RN, giving medications is that serious. As for the person who posted doing minor procedures by yourself, just be careful, it is fun to do new things, especially while in school, but you are still learning and it is not something that you should be so comfortable with as a student. Acting overconfindet can cost you in the end, and you might miss out more on the big picture of what is happening with the pt.
It makes me mad that student nurses, of course I was one once too, act overconfident. I sometimes here "I got this" those three worde are perhaps the most dangerouse because really you don't and are not proceding with caution and actually thinking about what you are doing, only doing a task without thinking.
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.
This is how my instructor did it; once we do our 3 checks with the instructor present, we can give the meds. And if the RN asks if we want to do meds, and we do (I WILL NOT GIVE ANYTHING I DIDN'T PULL THOUGH), then we can ask our instructor, yes, tell her we are pulling with RN, she says yes, we tell RN, and we pull with either, do our 3 checks, and we can give to patient. If there are 3 checks done, even if you are a student, you should know exactly what you are doing by then; if you saw one on the MAR you weren't familiar with, you would have already looked it up before pulling, and because we are students we are working under our instructor; so if our instructor is okay with us doing it, we are allowed; I have never not been able to give meds; I have turned down the opportunity before, as I was not with the RN when she pulled them; other than that, I have had someone with me to do checks and then give med; however, if it was my license a student was working under, I sure wouldn't co-sign a med I didn't see puled and admin....so that's both sides of it, but as a student, I have always gotten the instructor's permission, wither giving with RN or CI, and sometimes they are in there when I'm giving them, sometimes they have to move on to another student. We may be students, but when we are in clinical, we are rarely doing anything we have not done before with the instructor seeing us doing it at least once, usually checkoff and once in clinical, and then we kinda do our own thing once we have permission. If a student tries to do something they don't know how to do.....well, then they are gonna have issues in general....We are taught to only perform what we have been taught to do, checked of on, and performed previously, period.
It's very presumptuous to assume student nurses are demanding to pass meds and are overconfident. That's not been my experience. If anything, for better or worse I am often pushed out of my comfort zone by classroom and clinical instructors. A first semester student may not even know what state nurse practice acts are, so instructors should know what their students should and shouldn't do. And students should inform themselves, also. But it is wrong to assume overconfidence is why students are passing meds. Some states and facilities seem to allow it, and in other situations it's likely often the case that they're doing what their supervisor tells them to do without knowing the legal stuff.
Also: as an RN you can refuse a task and go to a supervisor or a different job if it's a frequent thing that you are asked to do something questionable. It's considerably more scary for a student who doesn't yet know nursing scope (we are in school to learn that) and refusing to do what an instructor says is sort of saying "I'm a student and I know better than you." Students get yelled at and intimidated for that, at best. Maybe a good lesson in pt advocacy and thick skin but I'm not an expert in nursing yet so it would make me nervous. I've done it, but it ain't pretty.
Specializes in LTC, CPR instructor, First aid instructor..
In my state, the RN must be standing at the bedside, but the SN can administer any medication, as long as the RN is there.
The reasons, are numerous:
1. It ensures the medication is being dispensed correctly...even some PO meds need to have vital signs taken prior to administration. This is especially true with IV medications and to ensure compatablity with current IV medications.
2. It ensures the right patient..you don't want a student walking into the wrong room...students do not have this "automatic" check yet b/c it is not yet habit.
3. It ensures the right dose.
4. It ensures allergies are checked on the armband or chart, as appropriate.
t.
How true. I see so many shortcuts being taken now, especially with the charts. If nurses didn't check them from time to time, many would not be opened, and many patients have been prescribed or given a medication they are allergic to. My firsthand allergic experience as a former patient.
SusanRN82
32 Posts
I've read some of the other posts and agree that you should check your state's Nurse Practice Act. I would bet that there is some language in there about the ability of someone to practice nursing, incidental to a nursing education program of study that is approved by the Board of Nursing. There should be school & facility policy about the conditions under which a student can administer medications.
Also, no one ever works under another person's license. However, the responsibility and accountability of nursing care remain with the nurse, meaning that the nurse should always ensure that the individual performing a task has the necessary educational preparation and competence in order to perform the task safely.