What is my legal and Ethical Obligation?

[tripletsgranny1]

While on another nursing unit the other night, I witnessed a RN calling in a prescription for another nurse. Nurse #1 asked nurse #2 to call in a refill for her. Nurse #2 requested her birthdate, drug and dosage needed. She then called the prescription in to a local pharmacy under the name of a doctor that practices on that unit. The doctor was not present and had not been there all evening. These nurses seemed very comfortable with this transaction.

Where do I stand as a witness? By doing this in front of me, have they pulled me into the crime?

[Merlyn]

Stay out of it. Don't be an avenging crusader. It didn't concern any of your patients. The road of unemployment and law suits are lined with good intentions. Forget about it. You don't know what when on before you got there. all you saw was a nurse making a call for another nurse. She could have talked to the doctor on the phone. The other nurse could have talked to the doctor earlier that day. If it was a refill, what crime? No one was hurt. Leave this one alone.

[thehipcrip]

The OP states that the second nurse asked the first nurse for *her* birthday, the drug and the dose, not for a patient's birthday, drug and dose. Seems clear to me that the first nurse needed a refill of a personal prescription, and asked another nurse to call it in using the name of a doctor who works that unit -- a doctor who had not been present that day to prescribe a refill.

As to your obligations, I'm inclined to say there may be an ethical obligation to let the DON know of this transaction if the script that was called in was for a controlled substance *and* was a med not typically prescribed by physicians practicing in the same specialty as the doctor on the unit whose name was used.

[NurseCard, ADN]

OP, are you worried that you are being unethical by not doing anything? Immoral? A bystander to something horrible that you know you need to report?

If that's the case, I'd say that there's really nothing that you need to report, so relax and take a deep breath. Like others have said, you REALLY don't know the whole story. That doctor may have written the script for that nurse earlier in the day or something. The nurse who actually received the script, probably knows that she can't just call in her own script. Whatever the case, you don't really know that the nurses did anything wrong, so relax.

If on the other hand, you are just being nosy , best to just stay out of it.

[Altra, BSN, RN]

How in the world could you possibly know whether or not the physician originally wrote the Rx for the nurse as a favor? This has been common in some units I've worked in.

How can you possibly know for sure that the physician had no knowledge of this? Just because s/he was not physically present at the time of the phone call to the pharmacy ... so what?

Based on what you have written, I can conclude nothing other than you seem to be jumping, no, leaping to unfounded conclusions ... and ready to act on this shaky information.

[xtxrn, ASN, RN]

Seems if this was something the doc was aware of, he would have either called in the rx him/herself, or gone back to the office and had his staff nurse call it in while noting it in the chart.

Really lousy situation. If the nurse calling in the rx is not working for the doc who prescribed the drug, that could be a crime. Ever seen the police pick up someone from a pharmacy who called in their own stuff (essentially the same)???? Not pretty.

[oshkosh20]

If the doctor was aware and gave the ok for the nurse to call in the prescription for another nurse then fine, no wrong doing. Now if the physician was not even aware of the prescription being called in, there could be some major legal ramifications. Fraud, Practicing Medicine without a physicians license, losing their nursing license, fines, jail time, etc. This could be reported to the DEA for further investigation. You might just ask the Doc too if you know him well enough? Sticky situation.

[honeykrown, MSN, NP]

Doesn't refill mean the doctors already wrote a prescription before for this person. and if the OP can elaborate, is this second nurse acting as the doc; as in given the info: Pls i'd like to call a refill for X and X, this is Dr. Y, then its illegal and if s*&t hits the roof, you might have to defend yourself but if not stay out of it. You dont know the whole story

[rn/writer, RN]

If someone asked YOU to call in a prescription and just said the doc would be okay with it, I could see where you'd want to investigate further, talk with the doc, and possibly take some action. But for you to make assumptions based on limited information or to go digging for more information when you simply overheard part of a conversation--that seems more like being a hall monitor (and looking for trouble) than being a co-worker.

If something hinky is going on, it'll probably surface sooner or later without any help from you.

[BluegrassRN]

Our hospitalists offer limited services to the staff. There is no office nurse to call in scripts; either the hospitalist does it, or asks one of the other nurses to do it. I always offer to do it for them, because I appreciate the service. So perhaps someone has overheard me calling in a script for a coworker; I always verify directly with the doc, but I'm happy to help out. I'm not doing anything illegal.

If the doc is aware, then there isn't anything to be upset about. If they are doing this without the prescribing physician's consent, it's a huge issue.

[canoehead, BSN, RN]

Another approach is to speak to an uninvolved pharmacist, maybe someone you know and trust. Ask them what safeguards are in place to prevent scripts from being called in that the doc hasn't approved. There has to be something...otherwise Joe on the street could start calling in scripts on behalf of their doc, posing as a nurse. They'd just have to know the language.

[CrunchRN, ADN, RN]

Since you are not involved, I vote stay out of it.

You can only lose! Trauma is so right.

[Munch]

Nurses can call in scripts to the pharmacy in my state...NY(unless it's a scheduled II drug). I had oral surgery a few years ago and the dentist prescribed vicodin(scheduled III med) and the nurse called in the prescription no problem..I obviously just had to bring the hard copy script and give it to the pharmacy. That was a long time ago...I was 19 and had my wisdom teeth taken out. Then again it was a long time ago the law could have changed.