Nursing Authority

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Specializes in Emergency Nursing.

Does a nurse have the authority to ask the pharmacy to provide another form of a medication than what is prescribed?

I can't seem to located this in my book anywhere.....

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Specializes in retired LTC.

Pharmacies can only dispense what is ordered as it is ordered by the physician/NP/PA. You can ask, but if they've filled it, it's filled. Remember that some entity (be it private pay or insurance or subsidy) will be billed for it and that duplication may pose a problem. And it's not easy to credit returned medication, even if it's unopened.

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Specializes in Emergency Nursing.

Thanks so much!

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Specializes in Trauma, Teaching.

You can ask for a liquid instead of a pill, but not for a form that changes the route.

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Specializes in Acute Care, Rehab, Palliative.

You can ask the doctor to change the order to another form.

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We often ask pharmacy to provide liquid KCL for a patient that has trouble swallowing the non-crushable KCL tablets. Another example is asking for a chewable ASA instead of the coated one. Same route, same med, just a different preparation and we don't need a doctor's order.

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Specializes in Emergency Department.

I have not bumped against this particular problem myself, however, it makes sense that a nurse can ask pharmacy for a different form of a medication that would be delivered via the same route. To me, it would seem that this way you are not changing the medication, or the route that it is delivered, just whether or not it comes in a particular form or not. I look at this in the same way as us delivering a pill or a powder that we crush from a pill. The medication is still there, it is the same drug, and if you put it in liquid so that the patient can just slurp it down rather than swallow it whole, it is still the same drug being delivered by the same route – PO.

It also makes sense to me that a nurse cannot change the route of delivery because many medications, as we all know, can be much more potent if delivered IV at the same dosage as a PO dose... Somehow, I think that I would react differently to a 5 mg PO dose of diazepam, than I would to a 5 mg dose of diazepam IV.

In effect, I think it makes great sense that if a nurse wants to change the route of a drug, a new prescription must be written by an authorized prescriber. The last time I checked, nurses aren't usually authorized to prescribe medications…

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