Receptionist drawing meds

ageless · May 26, 2003

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Unlicensed personnel DO NOT work under the license of the RN or Doc. That is a myth.

Do you drive under someone elses license? UAP work under the direct supervision of the nurse or physician. This is completely different.

The licensed professional would be responsible for giving an unknown medication which can in turn be interpreted as conscious disregard/ neglect.

PediRN · May 26, 2003

A long time ago, when I was a medical assistant (i.e., high school graduate with NO medical training whatsoever) I drew up immunizations for the MD to give. I thought it was cool at the time, now all I can think is that the doc was a major doofus for letting me do that!!

I would definitely not give imms that someone else drew up. I wouldn't even give a med drawn up by another nurse if I didn't see her do it with my own eyes.

**canoehead, BSN, RN** · May 26, 2003

Seems to me that if the doc is aware of the situation, and he gives the meds she has drawn up that you are no involved in their malpractice if an injury should result, beyond formally making sure they know that this is not the standard of practice (write a letter)

laurasc · May 27, 2003

Well, I spoke with the College of Nurses of Ontario (CNO) which is my governing body. According to the standard of practice set up the CNO, I am perfectly correct not to give any medication that has been drawn up by the receptionist and I am technically not responsible if there is an error made. The practice consultant I spoke with didn't comment much on the doctors allowing her to do the vaccines, just let out a bit of a sigh. :rolleyes:

I also had a chat with my bosses. I did talk about the receptionist drawing up the vacs. They repeated what Helllllo Nurse said: she is doing these tasks under their authority and as such is allowed to do so because they trained her. I told them that I function under a totally different set of rules and for the sake of protecting myself, them and the receptionist, I will not give any med she draws up. They didn't seem happy about it, and talked about telling her not to do that anymore, but no other decision was made. For all I know they may have talked to her and this will be the end of the discussion. If she does continue to do that, then I will take your advice and write them a letter absolving myself of any responsibility.

This whole issue with the vaccines have gone from bad to worse actually...but for a somewhat unrelated reason. The week I started working there the fridge where we keep the vaccines started to die. The nurse that was responsible for it (she's the nurse of the other office, we share a nurse's station and fridge)didn't pick up on the higher temperatures and the following week was on vacation. I'm the one that caught the problem and contacted the health department. The past few weeks have been a nightmare of lost vaccines, me trying to protect the vaccines we were given to us, maintain a semi-adequate supply and trying to get them to get a new fridge. On top of that I only work 4 days a week and when I'm off no one bothers to record the fridge temperatures. I'm getting no cooperation and today one of the docs got mad at me for telling the health department the truth! :confused:

Part of me wants to run from that job screaming, the other part of me.....well....I don't know. Problem is the hours are exactly what I want and the pay is better than average. We need the money desperately and nursing jobs (at least office nursing jobs) are scarce around here.

Sorry to vent like this. I'm really frustrated. I don't regret leaving my old job, but I'm wondering if I made the right decision coming here....even though the job itself is quite interesting.

Thanks again!

SmilingBluEyes · May 27, 2003

maybe you need to leave office nursing. Good money or not, can you live with the lack of ethics on the parts of your employers? I guess it's up to you.....good luck.

laurasc · May 27, 2003

Originally posted by SmilingBluEyes
maybe you need to leave office nursing. Good money or not, can you live with the lack of ethics on the parts of your employers? I guess it's up to you.....good luck.

Well, maybe THIS office. My previous office job was great and the doctor was above board.

I think I'm going to start looking for something else.

Thanks for letting me vent!

Laura:)

MyFunnyFace · May 27, 2003

Goodness, LauraSC, It sounds like you are trying to do your job with professionalism - yet, you are met with adversity by those whom employ you??

It's your license, and no matter what, you owe YOURSELF: keeping your license, feeling good about your standards and ethics, let alone your dedication to the patients.

I think you had a super idea- look for a new job, soon!

Good luck, and I am sure that your good morals WILL pay off for you!

God Bless you!

Hellllllo Nurse, BSN, RN · May 28, 2003

Laura,

Can you get your old job back? If not, if you are friendly w/ the doc you used to work for, maybe you can talk to him. Does he have any colleagues looking for a good nurse?

In the mean-time, be proud of yourself for doing the right thing, and not giving in the the pressure. Always CYA, no matter what!

Also, aside from letting them know it's not being done, there is nothing you can do about the fridge temp not being recorded when you aren't there. It took me a long time to learn to just do my best, and realize I'm not responsible for, nor do I have any control over what goes on at work when I'm not there.

Getting to a place where I could just let go of fretting over what other people are, or are not doing really helped me as a nurse.

Whatever happens, all the best of luck to you!

gwenith, BSN, RN · May 28, 2003

Laura - your state/country HAS to have a drug administration act of some kind and it usually details who can and cannot be responsible for administration of drugs. It is often hard to find legislation. The people to ask are your professional body/union, a local friendly pharmacist or your local librarian.

I totally agree with ageless, the myth of working under medical licence is just that - a myth and a dangerous one. It dates back to "Vicarious Liability" tort. Under vicarious liability the individual is not sued but the institution/corporation they work for is sued. This is the norm here in Australia at present, however NOTHING stops the institution/corporation from suing the individual in turn. But even under vicarious liability each individual is judged to be ultimately accountable for his/her own actions.

Run this past the receptionist. A suit is brought against the medical practice alleging that one of the children given the vaccine has subsequently developed a bad temper (remember under common law you must prove that the link does NOT exist) In the course of this case it is discovered that she has been drawing up the medications. Close your eyes and imagine the glee that an attorney would feel on finding out that fact. What sort of training did this receptionist recieve? Was it one afternoon or has she had repeated lectures on medication administration, pharmacology, infection control and assessment of mathematical ability. What evidence do they have to support that this training ever took place? I can tell you that the first piece of advice the DOCTOR'S attorney would give him/her is "deny everything". Given the choice between losing thier own licences and hanging you and the receptionist out to dry - which one will they choose?

It is hard when you walk into a mess like this the best thing you can do is what you have already done - make your opinion known as soon as possible. The longer you leave this situation the more culpable you are. Keep records - including a copy of this thread - download it or e-mail it to yourself as it is all EVIDENCE that may, someday help fireproof your backside.

SmilingBluEyes · May 28, 2003

Gwenith brings up some VERY valid points here. Better watch out for thyself!