RN with expired license calling in scripts for family...family wants us to do it too.

[BettyBoopsRN]

I wanted to ask everyone's opinion on a situation. I have 2 aunts who are RNs. One is still practicing, and does not get involved with doing shady things for our family related to medicine. Because of this my family has considers her the less competant nurse.

My other aunt stopped practicing nursing when I was about 15 (I'm in my mid 30s now) and is dianosed with bipolar. I remember gowing up her being the go to nurse in the family, everyone saying she should have been a doctor yada yada.

Well, I'm been a nurse for nearly 10 years, and I can now see how she "operates". She dianoses members of my family, and will call in scripts. I don't know which doctor she is using, but I doubt he or she knows. I do not do this, and take the same position as my other aunt, while I don't mind giving a little advise, when someone comes to me that has not been to a doc in 20+ years (my dad) asking about something that could be many different things, I tell him he really needs to get into a doctor. Also my hubby is a P.A. and they have asked him to call in scripts for them and he won't do it, and I agree with this 100%.

This past winter my dad was having abd pain (he did not tell me about it, as I am of no use because I will not dianose and treat him over the phone). He called my aunt (the one that is no longer working, and she told him he had shingles (*****) and that the pain would last for months. SO about 2 months later, he finally said something to me...and I told him he needed to get into the doctors, that why would she pick that diagnosis and give him this false sense of security, so he ignored this on going pain?? He said she asked him if he had a rash and he said he had a blister in his abd, that she never even looked at...

I aksed his a few questions and found out his abd was tender and distended...ugh...I told him to go into the ER...and he said No, it was just linger pain from shingles like my stupid aunt told him.

2 days later he developed a fever, and he called me, and I told him to go into the ER now, or he my die...he went in that night and he had diverticulitis and his bowel had already begun to perferate...I was so mad at my aunt. I told her don't you dare play doctor with my dad again, but she's out in lala land an told me that my dad said he had a blister so it sound like shingles.

Thankfully my dad was ok after a long hospital stay. After finishing abt, he was supposed to go back and have the microperforation repaired...and hasn't...

Anyway I told him, just because me and my husband don't phone diagnose or call in scripits (which I can't even legally do) doesn't mean you should use my wacko aunt for medical treatment. I said she pretty much gave you advice that could have killed you.

Anyway, yesterday my cousin texted me to ask my husband to call in antibiotics for her, and I told her no. I told her I'm sorry this family is used to my aunt handling things the way she has for years and years, and I'm sorry that you all think of that type of conduct as bein a good nurse, but its not. THe wierd part was she said she "went to the ER a few weeks ago for a uti, and the doc said you DH could call in more meds if I need them, so would he call in so macrobid cause the uti didn't go away"...

Even DH thought this was weird because none of his docs would do that, and actually none of the docs would know she knew my husband unless she told them...also he said no doc would be like "hey if this macrbid doesn't work, take some more!" Her text seemed like she was lieing...HD said he probably won't say anything to the doc because what my cousin said sounds like complete BS anyway. He said tell her to go back to the ER and get checked again. Either its resistant, or its something else. And we also know that my cousin sleeps around (she tells me) so maybe even an STD? He said usually when someone comes back for a second visit for a uti, then they will check for certain stds. I also know from her telling me that she has hpv...basically there might be more going on there ,and it doesn't make sense what she said in her text...

I have a huge family (HUGE) and I do not want my husband to be the next Aunt X that every one thinks will do everything on the side for them. Actually, my dad asked me last year (before the abd pain) if he could go into DH ER and get treated for free....Like he wanted my DH to "sneek" him in....smh

Now my concern is that my aunt will start calling in scripts (not narc just abt and BP meds etc) under my DH name. Basically DH said there's no way to know unless he calls every pharmacy in the area (for uncontrolled meds). I feel so bad that my family is doing this but he says don't worry about it.

I just needed to tell some other nurses about this. Its very upsetting that my family is doing this. I have no intention of reporting my aunt, because I don't know the details, but I now worry she will use my DH name....I have kind of always wondered which doc she is using when she has done this in the past. I am also annoyed that my family think me and DH (and my other aunt who is a really great nurse) are "not the smart" because we don't diagnose over the phone or call in scripts. My family has such a warped idea of what is proper conduct for a nurse that they see our conduct as something a stupid medical person would do, I think they mistake lack of intervention for not knowing anything...

Sorry about the long vent. Sorry for typos.

[chrisrn24]

Can you have some kind of hold put on your husbands scripts and make sure pharmacies call to verify his orders?? Not sure how it all works but some kind of call confirming "Hi, I'm from ABC pharmacy did you give Patient T a script for Keflex on 6/29/13?"

[Altra, BSN, RN]

I think you know this is blatantly illegal. Family relationships have zero to do with it -- in no state can a registered nurse without prescriptive authority prescribe anything, for anyone. Period. Ever.

If your aunt has not worked as a nurse in 15ish years ... she may not even hold an active license. Some states require a certain amount of recent work experience for license renewal.

This scenario is only possible under two conditions: either your aunt is calling in Rx representing herself as calling for Dr. X with Dr. X's knowledge ... which is fraud not only for her but also for Dr. X, as Dr. X would be claiming to have seen/treated the patient when s/he has not. Or your aunt is calling in Rx under the name of Dr. X without Dr. X's knowledge. This is fraud on different levels.

While we cannot give legal advice here at AN ... it is certainly possible for anyone to report suspected fraud to:

1. your state's board of nursing

2. your state's board of medicine

3. your local law enforcement

4. your state department of health

5. CMS hotline for suspected Medicare/Medicaid fraud

6. insurance carriers' hotlines for suspected fraud

[dishes, BSN, RN]

Write a letter to the BON it is up them to decide if there are enough details to pursue investigation.

[Marshall1]

Wow..soooo much going on here..lots of illegal things..just..wow.

[Jory, MSN, APRN, CNM]

These situations are tough because what she is doing is illegal and that puts the doctor she is using at risk as well.

I think the OP knows what she needs to do...even if it causes a family rift. I would report it to the police before she ends up killing someone.

[TakeTwoAspirin, MSN, RN, APRN]

Your aunt is practicing medicine without a license, and at some point she is going to really hurt if not kill someone. There is also a chance that she will drag you and your husband into this mess (like you said, you don't know whose name she is calling these meds in under). Your conscience should dictate to you what needs to be done here....

[BlueDevil,DNP, DNP, RN]

#1-It is easy enough to discover who's name she is using- look at one of the bottles sometime. It is is your husband's, obviously he must have her charged. Otherwise, alert the individual who is being named and let them decide what to do. In any case, you must alert the BON to what your Aunt is doing; you have no ethical alternative. You know that you must. If you do not, you bear some responsibility for the consequences. Your Aunt should probably go to jail. If she's smart, she'll plea and she won't. If she kills someone she will go to prison. AND someone will be dead. I am familiar with a similar instance and the responsible nurse is serving 11 years for involuntary manslaughter. And someone is dead. And you would bear some of that responsibility. I don't think you could be held legally responsible, but could you ever forgive yourself? Do you think the parents/children/loved ones of the person your aunt kills would forgive you if they knew you had the chance to stop her and decided not to, because it would be hard? It may seem hyperbolic, but you gave the example of how she nearly killed your own father. You know what you have to do.

#2 -As far as your entitled family members go, stupid is as stupid does. Stop texting people regarding their illnesses and practicing apologetics for good practice. The only appropriate response to inappropriate requests: "no, see your PCP" or "no, seek emergency attention," Whichever seems appropriate to the complaint. They will get the message eventually. If they do not seek appropriate care for their ailments, that is their problem. You are enabling them. Stop it.

#3 -I say this gently, and mean it in the nicest possible way. Grow up. You know better than this. Do not allow yourself to be bullied into dangerous and illegal behavior because it offends you that ignorant people do not think highly of you for refusing to break the law and risk your license and their safety.

[OCNRN63, RN]

What are you waiting for! Dime her out, RIGHT NOW, before something terrible happens and you both have blood on your hands; your aunt for calling in scripts, and you for being complicit in your silence. This family sounds dysfunctional on so many levels.

I agree with Blue Devil, it's just he/she is nicer than I am.

Call your BON. Now.

[JBudd, MSN]

You don't want to send your aunt to jail, I get it.

Now choose, husband who is ethical, aunt who is outright dangerous.

Who are you going to protect?

I agree with the other posters, you have a duty to report, family or not.

[JBudd, MSN]

At the very least, notify pharmacies that phone calls from this person, from a home phone are fraudulent. They can pass around a flyer.

[BostonFNP, APRN]

You really are obligated to report it, as tough as it may be.