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Discussion

Consequences?

I know a nurse who works at a doctor’s office. She wrote prescriptions, multiple times, for metformin for someone without him ever seeing the doctor. My question is: if this is reported to the board what will happen to her? The doctor? The person who received the prescription and had them filled? This happened in Alabama.

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    • Experts

    I think he or she will be in serious hot water with the BON and the police. That's practicing medicine without a license, foraging prescriptions, and theft. It isn't just malpractice, it's breaking state and federal laws.

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    Nurses in outpatient clinics can call the pharmacy on the doctor's behalf and authorize a refill on a prescription. We would not usually call in the first prescription, and certainly not for a patient who has never been seen in the office.

    So is the patient was seen in say, April, and got a 90 day supply of metformin sent to the pharmacy and has an appointment for October, and it is now August, the RN may call the pharmacy and authorize another 90 days.

    Let's not jump to conclusions that the nurse was acting outside her scope.

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    • Guides

    If you are the person who did this, you could lose your license if reported to the BON. Its practicing medicine without a license and is a serious offense. You can face criminal prosecution if harm came to the patient or if someone just decides to pursue it.

    The doc will not be in trouble, as they will likely testify that you did this independently of her/him, leaving you on your own for a legal defense that doesn't exist. If you stole prescription pads/papers to do this with, you are going to lose your job. If you wrote any other prescriptions with that pad or papers you will face separate charges for those as well.

    Nothing will happen to the patient. They didn't do anything wrong. This is 100% on you if you did it.

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    On 9/5/2019 at 7:06 AM, FolksBtrippin said:

    Nurses in outpatient clinics can call the pharmacy on the doctor's behalf and authorize a refill on a prescription. We would not usually call in the first prescription, and certainly not for a patient who has never been seen in the office.

    So is the patient was seen in say, April, and got a 90 day supply of metformin sent to the pharmacy and has an appointment for October, and it is now August, the RN may call the pharmacy and authorize another 90 days.

    Let's not jump to conclusions that the nurse was acting outside her scope.

    Yes the details matter. I am also in outpatient and send many refills, every day. When she said “without ever seeing the doctor” do you really mean EVER? Did the doctor tell her to send it?

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    • Author

    Yes I mean EVER. I can’t say for certain that the md didn’t but I know the patient has never even laid eyes on the doctor.

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    • Experts

    If the doctor is authorizing prescriptions without ever seeing the patient, then s/he is in hot water. Maybe he's hoping if he gets caught he can throw the nurse under the bus. If the nurse is doing this without any authorization from the doctor, then s/he is operating out of scope.

    We have to understand how you know this. It's entirely possible you don't have all the information.

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    I have had MDs (actually the LPN started the ball rolling) write me a prescription and I filled it in the clinic pharmacy. Never saw the MD. I worked at the clinic and couldn't get an appointment to see my MD for a refill so I asked the LPN of an MD in the clinic I was working and had no problem getting the refill. YMMV. Never laid eyes on the MD

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    I've seen quite a few times, where a patients doc was out (vacation, sick whatever). They wouldn't get their normal prescriptions renewed in time and a different doc in same practice would often ok the script. Having never seen the patient... or nurses in the office would ok the renewal to pharmacy, again for known patient, known medication.

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    So the person NEVER seen the doctor and has had MULTIPLE metformin prescriptions written for him BY the nurse? You know this how? Why hasn't he seen the doctor? How long have you been "witnessing" this?

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