I just passed my NCLEX and will be starting on an acute care unit next week.
I had a teacher tell me that if her children have friends over who have a headache that she can't give them ibuprofen because that's considered "prescribing medication." That sounds suspect to me, especially because she is in her own home and that medication is over-the-counter.
However, if she is right, that makes me worried that there are other seemingly innocent actions out there that are technically considered out of scope and that could put my license at risk.
Aside from the obvious parameters in a nurse's scope of practice, how do you learn what's okay/not okay for a nurse to do in strange situations like this? Is this something most nurses know or is it something that comes with time and experience?
She also didn't listen to me when I told her taking less than 600 mg of Ibuprofen is useless
Sorry if this is naive, but what is the rationale behind this statement? I've not heard that before. Is it unique to hip osteoarthritis and similar conditions, or are you saying in general?
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
Thanks everyone for that info. I figured something sounded off, but again, don't want to lose my license over something that could easily be avoided if I only knew.
I also should have corrected - by children I did NOT mean young children. Her kid is like 18 or 19. Sorry you couldn't read my mind.
If it sets your mind at ease some, scroll through your state's BON website and see the reasons why nurses have lost their license - most of it involves diversion of medications.
In regards to giving advice to family/friends - no, just no. Mostly for sanity purposes like KelRN said. But also I have seen some family members get pretty vicious and vindictive when something bad happens, so you never know. I have had no problems telling my family to ask their doctor instead of expecting me to give some advice.
Ha - okay, glad to hear it. So what about with things like a friend or family member asking you about symptoms they have? Is it out of scope to tell them what you think might be the cause, what meds might benefit them, etc...or is this just another example of me overthinking things?
Only common sense stuff. Proper dosage of OTC meds for occasional minor aches. Any chronic aches or issues, even just a sore back, they need to see their doctor.
It's unfortunately not uncommon for a chronic back ache to be cancer!
I love to joke with casual acquaintances who ask advice. "Ok, take off all your clothes and I'll examine you.,"
Patients look at me like I have a horn growing out of my forehead when I tell them I can't clip their toenails. You all know the hideousness of some of those babies!! Can't do it and I am A-OK with that
I typically "triage" people who ask for advice. Always referring them to their healthcare provider.
Only once have I recommended treatment....a family member called in a panic after giving her child the 2nd dose of a new medication....she described textbook angioedema. I asked if he'd ever had benedryl before (he had without incident), I suggested a benedryl and a trip to urgent care immediately. I didn't know a lot about angioedema at the time and was concerned about his airway when she said his tongue was "huge". When at the ER, they took him immediately and treated him for anaphylaxis.
Sorry if this is naive, but what is the rationale behind this statement? I've not heard that before. Is it unique to hip osteoarthritis and similar conditions, or are you saying in general?
Recommended dose for an adult taking ibuprofen for osteo is 1200-3200 mg/daily divided into 3-4 equal doses. So 600mg for the day would hardly be effective.
I would never give any child other than my own OTC medication, and if it is prescription medication you better bet I took my family member to the doctors to get that check up and prescription.
If family and friends know you are a registered nurse you will be asked questions...just be prepared to refer to provider, to mentally asses the patient and provide general information.
Wasn't there just a similar question in another thread?
I'm guessing it was the one asking if it was OK to give an OTC to an aide etc.
I must say, I find it a bit strange that the teacher used giving OTC to a neighbor's kid as an example. It's up for debate if that is practice medicine, but even as a lay person, can you imagine what would happen if that kid has an adverse reaction? Even if I weren't a nurse, I would never think of giving someone else's child a med unless that parent specifically told me to give the child a med from the child's own supply of said med; and even with that I would be a bit leery.
You'll get friends and family members (and even the occasional random stranger) who will ask you medical advice. I usually respond with something light like "its my day off, so you're going to have to call your doctor". Try to remain in your normal role(s) outside of being a nurse i.e.: wife, friend, daughter. Not so long ago, one of my neighbors came to my door with her hospital discharge paperwork and asked if I could help her with her dressing changes. I politely declined and told her I could be her friend, but not her nurse due to the liability, and being a nurse to me is too important to risk loosing my license. She was disappointed, but said she understood.
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Sorry if this is naive, but what is the rationale behind this statement? I've not heard that before. Is it unique to hip osteoarthritis and similar conditions, or are you saying in general?