Is this acceptable?

dream'n, BSN, RN · Apr 29, 2015

Medical Assistants can be certified or not. Some are on the job trained and there after call themselves a Medical Assistant. Medical Assistants do NOT have a scope of practice to follow and they are NOT regulated, unless they are certified.

Guest219794 · Apr 29, 2015

A couple of people have mentioned the OPs license. In what possible way could it affect her license if a receptionist give a shot? Or if a custodian does a heart transplant? Or anything anybody else does, unless she specifically instructs them to do it?

Anonymous865 · Apr 30, 2015

Full disclosure - I'm not a nurse.

I'm surprised that everyone has a problem with giving allergy shots from a vial a patient brings in. I've received allergy shots for many, many, many years. It is very common for people to get their allergen vials from their allergist and take them to another practice for injections. I've never heard of the allergist sending the vials directly to the other provider.

When I was working at a company that had on-site physicians/nurses, I would go to my allergist and pick up my vials and take them to medical at work. Then I could just walk over to medical to get my injections. My allergist always included the orders and schedule in the box containing the vials. The nurse at the company medical would give the injections per his orders. Whenever I was close to finishing the vials, the company nurse would tell me and give me a copy of my injection records. I would contact my allergist, and they would make up the next set of vials. Then I would go to the allergist's office, give them the copy of the injection records, and pick up my allergens and take them to the company medical.

I've known people who got their allergy shots at their PCP. They would follow the same process. They picked up the allergens at the allergist and took them to their PCP.

Someone asked why you wouldn't just get your shots at the allergist. The answer - time.

For me I was getting my shots 3 times a week initially. Then twice a week. Finally after over a year it was once a week. Every few years I'd develop new allergies and have to start all over at 3 times a week. Imagine how much time I'd have to take off work to get shots if I went to the allergist vs 5 minute walk to medical, wait 20 minutes, 5 min walk back to my desk.

If someone lives in a small town, they might have to go to another city to see an allergist. Does it make sense to have to drive to another city twice a week to get a shot that your PCP just 10 minutes from your house could have given you?

The only reason allergists don't let their patients give themselves the shots is there is a small risk of an allergic reaction, and they want you to have access to immediate care if you do have a reaction.

I was talking with my allergist about this today. He said they even have patients who are dentists or work for dentists and get someone at the dental practice to give them the shots.

I could understand your concern if it was some stranger off the street, but if it is an established patient of the practice, I think you are overly concerned.

Oedgar · Apr 30, 2015

When I worked for an allergist, any vials we sent out were accompanied by a list of what was in them, as well as a detailed dosage schedule... previous injection dates, etc. We also gave injections from other allergists, if the same information was sent. I would never give a random allergy shot without all of that info available.

klone, MSN, RN · Apr 30, 2015

As long as they've received training and the MD is okay with it, I have no problem with UAP giving injections. As someone else mentioned, that's a very simple task that we teach to patients and parents to do at home all the time.

klone, MSN, RN · Apr 30, 2015

Our x-ray techs are also doing nursing

What does this mean? How are they "doing nursing"?

And yes, I have found that a lot of nurses over-document.

betweenus64, LPN · Apr 30, 2015

Darn, I didn't mean to hit a nerve with some of you, was just concerned, and before going into this clinic to work again, note: I have been off for a few days in between shifts, and the day I go back, what happens......shards of glass left on the countertop after a glass vial was broken the days before I worked and almost med error, injection to the wrong patient....so my point goes out....the importance of training and educating the non-licensed staff is so important, documenting is also, this can be used for court records if court requested them, so I may be overly cautious, but my training, my education and my care for my patients is very important to me! When you watch a non-lic person use blame for not knowing or realizing the 8 rights to admini. (nursing 101) instead of implementing or learning from this almost made error, then I do question staff non-lic. doing anything!!!

By the way, has anyone asked non-lic staff if they know the rights? 8 rights? just saying....

NurseBulldog · Apr 30, 2015

I wouldn't be happy about it, but to be honest it wouldn't happen full stop where I'm from. Have you asked them about what they're doing?

In regards to the vials thing, a lot of patients are trusted with their own medications and it works well. Like today, patient comes to the treatment room and brings their dressings plus an ampule of medication.

nurseprnRN, BSN, RN · Apr 30, 2015

As to your specific question, the answer comes from your state Board of Nursing. They may have strict regs on what may and may not be performed by licensed and unlicensed staff; the physician may or may not be able to override that. For example, in most states, your physician cannot call his secretary, CNA, or MA a "nurse," no matter what he has them doing, because that's illegal.

I would direct your concern to the BoN, especially the ones about bad documentation and med errors, and to the state Board of Health. They all have RNs who are trained to investigate things like this and rely on standards of practice (and their "stick" is reimbursement, so the MDs generally listen).

RNsRWe, ASN, RN · Apr 30, 2015

Full disclosure - I'm not a nurse.
I'm surprised that everyone has a problem with giving allergy shots from a vial a patient brings in. I've received allergy shots for many, many, many years. It is very common for people to get their allergen vials from their allergist and take them to another practice for injections. I've never heard of the allergist sending the vials directly to the other provider.

I have. I've done it :)

When I was working at a company that had on-site physicians/nurses, I would go to my allergist and pick up my vials and take them to medical at work. Then I could just walk over to medical to get my injections. My allergist always included the orders and schedule in the box containing the vials. The nurse at the company medical would give the injections per his orders. Whenever I was close to finishing the vials, the company nurse would tell me and give me a copy of my injection records. I would contact my allergist, and they would make up the next set of vials. Then I would go to the allergist's office, give them the copy of the injection records, and pick up my allergens and take them to the company medical.

This part of your post talks about the very common, normal, customary practice many medical professionals allow and have no issue with. Like I said in my own post, bringing in a SEALED vial is quite different from an OPEN one, from which doses have already been removed (and potentially been contaminated with who-knows-what). Once the vial has been opened, it remains in the care/custody of the medical practice, and they are responsible for anything that happens to it. I have never heard of ANY practice allowing someone to take home an opened vial so that they could bring it BACK again. No way. If they want the vial back, they get to keep it; I'd want a new, unopened one for next time.

You describe a practice in which the orders are included in the box along with the newly-made vials; no one has any issue with that that I've ever heard of. Showing up with an already punctured vial? Like I said....nohow, noway.