Is Reading From a Medical Dictionary to a Patient Considered Practicing Medicine

xoemmylouox, ASN, RN · May 12, 2013

Depends on the state. In many employers can fire you for ANY reason they see fit.

brownbook · May 12, 2013

Legally anyone can be fired for any reason. Was it totally stupid and wrong that she was fired, yes. Is your friend an RN? Just checking....maybe if she is an MA or something like that it makes a little more sense. Did the office manager just happen to over hear the phone conversation? Or did she find out some other way?

Any patient with a computer can look up drugs on their own, or look at a book in the library or book store.

Any nurse giving medicine to a patient should, can, must know how the medicine works, what it does, and should, can, must, tell the patient information about the medicine.....this pill_____ will make you sleepy...I am putting the side rails up and giving you the call light.....this medicine is for your blood pressure..it is called a calcium channel blocker...then maybe a simple quick info on how calcium channel blockers work (if the patient seems interested.) This is an antibiotic called_____sometimes it causes diarrhea.

When you pick up meds at the pharmacy you get the whole insert from the drug company.

Unless there is more to this story, it was really wrong that she was fired.

MJB2010 · May 12, 2013

What is a CMA? I think reading from a medical dictionary was an odd thing to do. If a patient had a question about a medication the pharmacist or doctor would be a good resource. If someone is reading from a dictionary it indicates to me that they did not have a good base of knowledge as to why this patient was taking this medication or could not understand the info about the medication. There are a lot of medications that have multiple uses and some have off label uses. If the person answering the phone was unclear on why this particular patient was taking it, it should have been referred to someone who did know. I guess it just seems odd to read from a book. If you can't answer the question yourself, get someone who knows to help so info does not get misconstrue. I can see how it could be a liability.

roser13, ASN, RN · May 12, 2013

I think CMA means certified medical assistant.

OP, if you live in an at-will state, you're and your friend can be "legally" fired for any reason or for none at all. Is it possible that your friend was already identified as a problem employee and that this infraction was just the one chosen as the reason?

nurseprnRN, BSN, RN · May 12, 2013

It's not "practicing medicine" if all she did was read from a publicly-available resource. If, however, she offered any opinion about taking it or not taking it, or (and this is important) if the patient thought she was doing so (did anyone ask the patient?) then she is in the soup.

Agree with roser13 that this might just have been the last straw, and with everyone else that anybody can get fired for any reason or no reason as long as s/he is not in a protected class and the firing wasn't related to that.

psu_213, BSN, RN · May 12, 2013

I don't know that I would call it 'practicing medicine,' but it can be a fireable offense. Is CMA a medical assistant? At our ER, the nurses cannot offer any medical advice over the phone. I would imagine that the same applies to MAs.

Here's the issues I see:

First, most meds have multiple purposes. Did she say to the patient "well, according to the book, it could be given for high blood pressure or for swelling in your legs or to reduce strain on your heart or to improve your kidney functions." Patient: "what are you talking about reduce strain on my heart....is something wrong with my heart???" Can't imagine the doc will be to happy about the MA suggesting to the pt that they have a heart problem.

Also, what if the patient asks a question? Pt: "Does that med interfere with my tikosyn?" MA: "Well, in this book is does not say anything about an interaction." There are now huge issues for the physician if that answer was wrong. You would say, well if the patient asks a question, the MA just says she cannot answer that and tells the pt to call back. Now she has called into question the veracity her previous answers, and, in this hyper-customer service world, this is going to reflect very poorly on the office.

I could go on, but I think you get the idea. She needed to just say: "leave your number and doctor will call you back today" or direct her to call her pharmacy.

llg, PhD, RN · May 12, 2013

It may or may not be considered "practicing medicine," but it is certainly "educating patients about their medication" -- and I suspect that educational function is beyond the job description of your friend. In addition, the patient education occurred outside the context of an office visit and was based on your friend's independent judgment of the patient's situation, not on a physician's order. She is probably neither qualified nor authorized to make such an independent judgment.

It was really wrong for her to do what she did and her employer was correct in disciplining her. Whether she should have been fired or not is a judgment call that should have been made on the basis of the bigger picture of her overall performance, history, etc.

KelRN215, BSN, RN · May 12, 2013

People have a lot of misconceptions about what you can and cannot be fired for. If you are an at-will employee you can be fired for any reason (other than those explicitly forbidden by law like gender or race) or for no reason at all.

chrisrn24 · May 12, 2013

It may or may not be considered "practicing medicine," but it is certainly "educating patients about their medication" -- and I suspect that educational function is beyond the job description of your friend. In addition, the patient education occurred outside the context of an office visit and was based on your friend's independent judgment of the patient's situation, not on a physician's order. She is probably neither qualified or authorized to make such an independent judgment.
It was really wrong for her to do what she did and her employer was correct in disciplining her. Whether she should have been fired or not is a judgment call that should have been made on the basis of the bigger picture of her overall performance, history, etc.

I think this might be it.