Hi! I'm a RN in a rural community in Colorado. One of the dotors offices here takes advantage of "Rule 800" of the Board of Medical Examiners specifications on deligation of medical acts in a private physicians office. Has anyone heard of this? Basicly it says that a physician can have an EMT-B with only 6 weeks of "medical training" (or anyone else who dose'nt have there own licenses) do anything the physician tells him to. I pulled the rule out myself and read it. It says that the physician can delegate any task they deem reasonable. It says that the physican should ensure the EMTs competance but there is no way provided to monitor these providers.
The reason I am bringing this up is that I have seen EMT - B in this office give 10 times the dose of MS that was ordered because she didn't know the difference between mg and ml. I have seen another basic give an overdose of the same drug becasue the doctor handed her a full one cc syringe of MS 15mg/1 cc with the order to give 2 mg and so the EMT pushed the syringe down to the number 2. That same EMT tried to hang a "valium drip" but I caught that one before she did it.
This doctor has his EMT-Bs read his x-rays over the phone to him and then tells them what to do to the patient. Now I am pretty sure they don't teach EMT-Bs how to read x-rays in a 6 week EMT class. They also do sutures when he is not there and who knows what else. The kicker is that this doctor has been turned in to the board and they didn't do anything but give him a copy of Rule 800.
I have never thought of myself as an activist but I am very concerned about this practice and this rule. I contacted the Board of Medical Examiners and they said that there has to be enough evidence to stand up in court or they can't do anything which I guess makes sense. Unfortunatly, it is easy to control your documentation when you have non-professionals working in your office. This particular doctor for example documented that the correct doses of medications were given and that he in fact gave them. I was there. I know it isn't true but I can't prove it.
I'm writting this is to see if anyone else has an issue with this "rule 800". I am sure this doctors office is not the only one that abuses this power. It seems to me that this rule should be far more limiting and specific as to the acts EMTs or other non-professional can do. Pluse shouldn't there be a method to monitor the situation to protect the public from unethical physicians like the one I told you about? He specificly doesn't allow his Employees to identify themselves as EMT's unless the patient specificly asks.
I'm attaching this URL - I hope it works so if your interested your can read it yourself. If it does'nt work let me know and I'll tell you how to find it.
