Need of the Ordering physician to be in the building?

[witc]

I everyone!

I work in an outpatient clinic, and I do two or three infusions a month of Aredia, Reclast, and Ramicade. I am an RN with no other certifications than BCLS. My question is: does the ordering physician or PCP have to be in the building, or is it enough with the Urgent Care or on-call Dr being present?

Thank you!

[ashwee356]

Ultimately it is your state board of nursing you should check with. Then hospital or facility policies, and so forth.

With that said, I work in an outpatient infusion center which is located inside of the hospital. All of our oncologists are located about 3 miles away in a different building. We do chemo everyday based on their orders. We also do IV infusions for RA (like the medications you listed), blood, antibiotics, etc. None of those MDs are physically in the building either.

Hope this helps!

[KelRN215, BSN, RN]

I did chemo as an inpatient RN but the way the facility worked was that both the pediatric hospital I worked at and the attached adult hospital were affiliated with the outpatient cancer center across the street. All 3 institutions were attached via bridges. All the oncologists were employed by the outpatient cancer center but the adult oncologists were also "on staff" at the adult hospital and the pediatric oncologists were "on staff" at the pediatric hospital. Patients were followed primarily by the outpatient cancer center but if they needed to go inpatient, they went to whichever hospital was appropriate. Many pediatric chemo protocols require inpatient admission for chemo because of 24 hr infusions and such. Needless to say, the oncologists spent most of their time in the outpatient center doing clinic. The facility's policy was that chemo orders had to be ordered by the Attending. Rarely was the ordering physician in the building when we gave the chemo. There was, however, always a covering NP or Resident in house. If we needed the Attending, they could be paged.