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Discussion

Taking Call out of State

Hi all. So I'm a relatively new grad FNP (less than a year into my 1st NP role) and going to be taking call for the first time over Christmas weekend. I work in a state with full authority/no MD supervision though I don't know if that would be relevant to my question.

Our on-call basically just consists of things we can easily do over the phone or our work laptops: med prescriptions, image reviews, phone triage, etc. I wouldn't be physically called to a location and have been told I don't need to be home to take call. I just need to have my phone, laptop, and an internet connection to access our network.

My question is, from a licensing standpoint, am I "allowed" to travel out of state and still work as a NP/prescribe for my patients who will be in the state where my facility is? Is there some kind of provision where if I'm licensed in 1 state and working for a facility in that state but technically working remotely in another state (while simultaneously on call and visiting relatives) is it okay?

For instance, if I work in Vermont and want to go visit relatives in Pennsylvania am I allowed to practice as a NP while physically in PA? Or would I need to stay in VT? Or get an APRN license for the state where I want to travel?

In a similar vein, what if one of my patients is visiting a state where I'm not licensed and needs something called into a pharmacy there? Would it be okay for me to put that through?

These may be more BON-type questions, but I thought I would ask the AN FNP community. I just haven't encountered this scenario yet, but I know it will come up.

Has anyone had any experience with something similar? What are your thoughts?

I saw a similar thread from 8 years ago, but it also involved prescribing for a family member so I really wasn't sure what applied and what didn't or if anything has changed. Thanks in advance for your help.

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    Yes, my answer would be that you could. I know the entire field of telepsychiatry only has the requirement of the provider being licensed in the state where you are delivering services no matter where you are physically located within the country.

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    • Author
    Yes, my answer would be that you could. I know the entire field of telepsychiatry only has the requirement of the provider being licensed in the state where you are delivering services no matter where you are physically located within the country.

    That's what I'm thinking. I'll probably get in touch with my BON and ask one of my colleagues just to be sure. Thanks for your response.

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    • Experts

    I take call in Il and visit my sister in MO without problem. I do not prescribe outside of Illinois where I'm licensed. If my vacationing pt needs something I will prescribe to a walgreens CVS or walmart (a chain store) in IL and its up to them to get it transferred

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    • Author
    I take call in Il and visit my sister in MO without problem. I do not prescribe outside of Illinois where I'm licensed. If my vacationing pt needs something I will prescribe to a walgreens CVS or walmart (a chain store) in IL and its up to them to get it transferred

    Thanks for chiming in. So, if you're in MO visiting your sister and you end up taking a call for someone who needs a med renewed or something, how do you handle it? Do you just wait until you're back in IL before renewing it for them?

    I think what I'm the most worried about, is if I'm in PA and one of my VT patients runs out of their lisinopril (or something) am I *allowed* to renew it from where I am in PA or do I technically have to wait until I get back to VT? Does that make sense?

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    I think what I'm the most worried about, is if I'm in PA and one of my VT patients runs out of their lisinopril (or something) am I *allowed* to renew it from where I am in PA or do I technically have to wait until I get back to VT? Does that make sense?

    I would use a dose of good judgement in that situation. If this is an established patient you've seen before and you have no reason to pursue work-up or a face to face encounter to determine whether to continue the lisinopril or not, then there shouldn't be any harm in renewing the prescription and I see no shades of malpractice which would be your primary worry anyway.

    If this is a patient who you haven't seen before in over a year, has not come to the clinic for labs, and is asking to have lisinopril renewed, I would definitely think twice. I think your particular location at the time really has nothing to do with managing a patient residing in the state of jurisdiction of your license as long as you are following "what a prudent provider would have done" in that situation.

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    • Experts

    The pts I take call for are dialysis pts with very standard needs: BP meds, cards meds, DM meds/supplies. I take call only thru the nurses (RNs) that are located in the dialysis clinic where the pt comes (or is supposed to come) three times per week.

    So, I'm in MO, I get a call, I just okay the RN calling it in. If there is a reason I need to eprescribe it, I do so from MO to an IL pharmacy.

    I do NOT refill controlled substances this way at all.

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    • Guides

    I live in a different state from where I work. I am on call for the practice and will send in prescriptions as appropriate for my patients. I very rarely deal with controlled substances, so that is not an issue. Our patients are told that on call is for emergencies only. I will not do routine refills outside of office hours. I could never go home at night if I had to physically be in the same state as my patients!

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