Liability of teaching an outside nurse

Nurses General Nursing

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I work in a busy family practice office. We have a client that comes in for a routine injection. She wants a family member (a nurse) to start giving the injections. The doctor agrees to do this, but wants me to teach the family member to give the first one in office. The more I think about it, I'm undecided about it. What would you do?

You have to teach because you are the professional here :banghead:

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Specializes in Neuro ICU and Med Surg.
Hmmm.

Is that really much different than teaching a patient's family to give insulin or manage the patient's medications in general?

I don't think there would be a problem, but maybe someone else here will see one.

I totally agree. I had to give my brother injections and I taught my mom too in case I couldn't

I was doing infertility treatment and had to teach my husband to give me my im injections because I couldn't do them myself.

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Specializes in Pedi.
Here is the difference legally. When you are taking care of a family member it is recognized as just that. From the physician's office side of things, you would show the nurse/family member what to do (no matter if it is redundant) and then document that you taught the family member how to administer what ever to their family member (the patient). The family member being a nurse thing has nothing to do with anything here.

You should not however show a family member who happens to be a nurse how to do a procedure that you would not normally allow a family member to do. This is where you get into trouble.

What kind of procedures are you thinking of that you would "not normally allow a family member to do"? In the world of home care, I can think of very little that families are not allowed to do. Families manage vents, access ports, give chemo, give TPN, change CVL dressings, etc. Now, I would not teach just any family member to do all of the above but I've seen parents who do do it all. I am quite certain that there are lay people out there who know WAY MORE about vents than I do because they manage their chronically vented child 24/7.

Giving an injection is certainly something you can expect a family member or a patient to manage on their own.

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I am a HomeHealth RN. We teach family members to give injections/IV's all of the time! It is expected that a family member will learn certain injections like Lovenox. I have many patient's who have family members giving them B12 injections. There are many medications that Medicare/Medicaid cover. There are some that it does not cover like Nulasta for chemo patients

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I cannot advise you but this is my personal experience with a family member's doctor: I am an RN and I have given a family member injections before. The doctor knew I am a nurse and trusted me to give the injections. No-one suggested "training" to me. I gave the injections as I have been taught in my nurse training. Absolutely no problems.

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Perhaps the family member is a nurse, but is not at the bedside and just wants a refresher. I think it is great she wants to be "taught" how to give it correctly. I wouldn't be worried. In fact I LOVE teaching things like this.

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The patient wants the family member (a nurse, presumably licensed) to give the injections. The doctor wants the OP to teach the family member to give the first injection. The OP's post didn't say that the nurse family member wants to be "taught" to give the injection correctly.

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

Shouldn't a nurse already know how to give this injection? Or, is it one that is deep, z-track that perhaps said nurse doesn't know how to give? Interesting.... And, document everything!

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Specializes in Neuro ICU and Med Surg.
The patient wants the family member (a nurse, presumably licensed) to give the injections. The doctor wants the OP to teach the family member to give the first injection. The OP's post didn't say that the nurse family member wants to be "taught" to give the injection correctly.

Eventhough I was a licensed nurse when my brother started his injections I still had to do the first one on the office at the doctor's request. So the doctor may want the first one observed.

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OK, let me clear something up here. The client is not ill in the least. The family member is not going through hell with the client. In fact, if the client is of age, why can't she be taught to give her own injections? She is apparently unwilling, which I don't have a lot of sympathy for. I mean, put on your big girl panties! I cannot for the life of me figure out why I have to even be involved.

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You have to teach because you are the professional here :banghead:
So, the other nurse isn't a professional?
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Specializes in Med Surg.
OK, let me clear something up here. The client is not ill in the least. The family member is not going through hell with the client. In fact, if the client is of age, why can't she be taught to give her own injections? She is apparently unwilling, which I don't have a lot of sympathy for. I mean, put on your big girl panties! I cannot for the life of me figure out why I have to even be involved.

I'm not sure what the big deal is--pt wants someone else to give the shots. Why is that an issue? Either way you're going to have to teach someone to give them, either the pt or the person who will give them to her. I don't work in your environment but I would think that to cover the doc's butt legally, it wouldn't matter if the person being taught is a nurse, there would still need to be proof education was given, I could be wrong, though.

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