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Discussion

What is the compalint?

I was employed at an office for 2 1/2 Years as a LPN. I recently quit because of this issue on my own not fired nor was I ask to resign. The NP I worked for was out on maternity leave and it was always the practice to give patients refills on their medications to hold them to their next appointment so I continued to do this while she was out. One of the attending physicians in another office who was somewhat covering for her said that I wasn't authorized to send in the refills and I got a written disclipinary action as well as he said he was sending it to the board of nursing. I don't understand what I've done wrong as I just continues to do what I have always done. When she returned she told them that it was the practice to send in rxs as I had done. The refills were for birth control and ssris that's it. I am devastated that this is going to the board I've never had anything against me. Is this something that I could lose my license for ?

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    Sounds like refilling meds to hold until appointment is within the NP's scope of practice, but it isn't in your scope of practice, so therefore it isn't the same thing.

    It shouldn't be difficult for a provider to cover for routine refills for a planned absence, though, by writing for more refills ahead of time or letting them know who to contact in the interim.

    I'm unclear as to what "somewhat' covering means, because the inexact term can easily lead to the confusion and higher risk of error even with routine meds. Although it isn't clear why the attending plans to proceed with the complaint if he found the NP's explanation reassuring.

    Anyway, there is no way to predict what may happen, I would absolutely seek professional legal advice at this point, even though you decided to quit your job before doing that. The best approach is to be honest and take responsibility for your actions. It's for every licensed nurse to know their own scope of practice.

    Sorry this is happening to you.

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    • Author

    I guess it's just been so confusing to me as I have done the refills the same way for 2 1/2 Years and all of a sudden because a different attending looked at it it's a problem very sad time for me

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    • Expert

    This is an example of personnel in the employer supervisory chain doing "left of center" things involving subordinates and then when something goes wrong, the subordinate pays the price. One should always know whether or not they are following their own scope of practice. You follow the rules or you don't, your decision. But you should do so, informed of what those rules are. If your gut questions something the first time you are asked to do it, or you are told "that's the way we always do it", then something is telling you that you need to take heed.

    If you question a practice and the facility policy and procedures manual does not address it, you can contact your state board (recommend you do it in writing) to get pertinent information from the board. Their answer should guide you on what to do next.

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    you are practicing medicine

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    unfortunately, this is out of your scope of practice. I am so sorry this is happening to you :(

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    The issue is that you didnt have permission from the NP to call in the meds at the time you were calling them in. You would need to notify the NP each time that a patient requested a refill and with the NP out on leave it wouldn't have been possible for you to get permission. So essentially you were authorizing the meds and there was no provider involvement.

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