Sign prescription for MD?

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At my new position in an ER it is apparently common practice for one particular MD to not sign his own prescriptions. He leaves it blank and expects the RN to sign it. Is this legal in TX? I’ve never seen this done at any other ER.

Specializes in NICU/Mother-Baby/Peds/Mgmt.
On 2/4/2020 at 9:21 PM, TXERRN84 said:

Thank you- it literally prints out 3 feet from his desk- he just doesn't feel like it, so now "everyone" just does it for him and I'm a weirdo because I don't want to and I'm not going to.

Lol, you're not the weirdo unless it's considered for the smartest one there to be weird....

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One of our Doctors leaves the prescriptions on the printer. To get the discharge done and over with, I walk it over to provider to have them sign it.

If the Doctor refuses to sign, leave it without a signature. When the doctor gets repeated calls from the pharmacy, they might start signing. Fill out an incident report, likely you can do this anonymously? It is not fair for the patient to be delayed at the pharmacy, but why should you lose your job? Don't put your job at risk.

I know they are supposed to sign, even with the electronic signature. For your states do all prescriptions need an ink signature if the medication is not a controlled substance?

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Specializes in Med-surg, school nursing..

Our system prints out the MD's name and some other number (not DEA) on non-controlled substances, these don't require a signature in our area. However, the controlled's do. And I can't imagine that it would be okay for you to sign his name on a controlled substance script.

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On 2/3/2020 at 12:16 AM, TXERRN84 said:

At my new position in an ER it is apparently common practice for one particular MD to not sign his own prescriptions. He leaves it blank and expects the RN to sign it. Is this legal in TX? I’ve never seen this done at any other ER.

Not legal. You can call in a prescription, but in terms of actually WRITING them? Uh...no. You'll be putting your license on the line if they are opiates.

Question: How are these getting filled by the pharmacy? Most pharmacies will reject with a signature that reads Dr. John Smith/Karen Jones, RN

If people are SIGNING HIS NAME? That is what you call a forgery and not only can you lose your license, you can go to prison.

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Specializes in Intensive Care/AG-ACNP Student.

I know in some family practice clinics the nurse and doc have worked together so long they have a shorthand down pat. He tells the nurse to give a shot of whatever and states an arc, nurse writes it down, MD comes and signs the script after making sure it’s correct. What the OP described is incredibly illegal. If that ever happened to me, I would call leadership and go straight up the chain of command AS WELL AS calling the legal department. Our license is too valuable.

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Specializes in SRNA.

I think it's silly. As far as the legality/liability - yes, it is illegal. IMO it's not that big of a deal. It's an annoyingly dumb problem. I wouldn't sign it. Technically you can call in all legend drugs to the pharmacy anyways (correct me if I'm wrong). BUT, signing anyone else's name is illegal. So common sense says - it's not a big deal. And this is why people have been doing it. However, the law says no. It's technically forging a signature. You can't delegate signatures.

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Specializes in ER.
6 hours ago, TriciaJ said:

Lordy, I can't believe nurses are going along with this. One bad reaction or someone starts looking into his prescribing habits and he can play ignorant. You know how we're always telling people not to be so afraid of losing their license? If you're going to participate in this practice be very afraid.

I'm glad you've reported this up the chain of command. Someone needs to stop this game. Bummer it had to be you and kudos to you for stepping up.

Thank you- I had never been on this forum before this and it is so supportive!

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Not only is it illegal but I’m pretty sure you could loose your nursing license doing this!

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On 2/3/2020 at 11:52 AM, JKL33 said:

I was familiar with a place where something like this was common. In that instance they were writing out the prescription then signing with [physician's name/Nurse signature]. When I asked questions/informally protested their rationale was along the lines of why I would think this is entirely different than taking a verbal order ("So you have no problem writing an order in a chart, applying the physician's name to it and then signing your signature--which is also a prescription?").

So, I simply wrote the verbal order on the RX just like I would in a chart, and on the sig line I wrote "VORB Dr. X/[my sig]." I never heard anything more about it and eventually the whole practice went away. It was before prescribing/e-Rx was integrated into the EMR. I didn't feel wrong about this because I always documented this in the chart so there was a proper record of it, and only ever wrote out prescriptions that were indeed told to me as verbal orders.

I wouldn't give the appearance of signing anyone's signature, which is to say...forging it. That was the line I wouldn't cross.

Just go to your manager and say you're unable to do x, y, z. They may take care of the problem for you; I have a decent guess they don't know this is going on.

Even verbal orders eventually need to be signed, though, no? So their rationale still makes no sense to me. For example, when we would get an admission in ltac, we would obtain telephone and verbal orders. We entered them in the emar which got sent to pharmacy to fill. Then we'd print the orders out and put them in a folder for the doctor/NP to sign when they came in.

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Specializes in ER.
1 hour ago, Bwolfe1 said:

Not only is it illegal but I’m pretty sure you could loose your nursing license doing this!

I think so too- I was trying to find hard proof of that somewhere. I couldn’t find it on the Tx BON site

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1 hour ago, Orion81RN said:

Even verbal orders eventually need to be signed, though, no?

Yes, and I don't know what my peers were doing and don't care, but as for me I was writing it in the chart as an order along the lines:

"Discharge Rx: [Blah, blah, blah, whatever the doctor told me] VORB/[Dr. Name/my sig]" and it was eventually co-signed.

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On 2/5/2020 at 6:37 PM, TXERRN84 said:

I think so too- I was trying to find hard proof of that somewhere. I couldn’t find it on the Tx BON site

You don't need to find it on the BON website because in school nurses should have been taught you NEVER sign for the MD without adding your name. Ever. End of story.

The DEA is the one that will put you in prison...not the BON. They will bypass that whole operation.

I would pull up your disciplinary actions. You won't have to read too far before you'll find nurses that have been suspended for doing exactly that.

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