When a new NP how do you complete prescriptive duties when need MD involvement?

[rnattorney]

Hi all. I had a prior thread that did not ask this question quite right.

Before we can prescribe medications in my state you are required to have a MD sign that you completed a 1800 hours after graduation and APN certification under his preceptorship that involved the APN prescribing medications.

Huh? Can you explain to me how you do this? So if your state required that you worked with a physician prescribing medications.....but do not have your own prescriptive number or license yet.....do you work with your physician and diagnose and treat patients and if a medication is necessary do you write it out, not sign it, tell the patient to wait a minute, then go find the doctor and get his approval and he signs it?

What is legally acceptable in your state if after graduation/certification you need to complete hours before you can get your prescriptive authority but must have "prescriptive experience".

Help me understand.

Thanks!

[amberfnp]

rnattorney,

I do not know the answer to that question but I had just looked that up on my state BON site and have a similar requirement. I'd like to know as well. Anyone?

[Gator FNP]

I live in Florida, we do not have this requirement. What states do you both live in?

[amberfnp]

I live in VA. Actually I didn't read the page in it's entirety. Now that I have re-read it, sounds like my pharm class is enough...this was just revised this year.

"An applicant for prescriptive authority shall meet the following requirements:

1. Hold a current, unrestricted license as a nurse practitioner in the Commonwealth of Virginia; and

2. Provide evidence of one of the following:

a. Continued professional certification as required for initial licensure as a nurse practitioner; or

b. Satisfactory completion of a graduate level course in pharmacology or pharmacotherapeutics obtained as part of the nurse practitioner education program within the five years prior to submission of the application; or

c. Practice as a nurse practitioner for no less than 1000 hours and 15 continuing education units related to the area of practice for each of the two years immediately prior to submission of the application; or

d. Thirty contact hours of education in pharmacology or pharmacotherapeutics acceptable to the boards taken within five years prior to submission of the application."

Thanks for replying though!

[emtneel]

I also come from a state (Colorado) with 1800 precepted prescribing hours.. its ridiculous. I may never even work in this state, as the need for NPs is low to non-existent (one of the few states).

Currently i do locums tenens (traveling work) and i just collect the needed signatures from my "precepted" physicians.

Its all very wierd. Currently I work in CA, have a temp license b/c the CA BON can't get their act together.. (they have my documents for 7+ months now) so i can't get prescriptive authority yet. I have a supervising physician, so basically i just call the prescriptions in under his name. I work independently, and i've met the guy once.

Before I was working in Massachusettes, where I was required to have a special prescriptive authority license, as well as DEA, BUT a "supervising" physician's name has to be on the script, okay whatever... But what really irks me is that I am the one prescribing the medicine and my name doesn't even go on the bottle!! So the patient can't remember who they saw, look at their pill bottle and say oh Dr.so and so prescribed me this, (which they really didn't, I did) and if they have any problems they call the Doc and he has no idea what they are talking about b/c he never saw them, has to locate the chart, etc. way more work for the Doc.. Who ever thought up this ridiculous system! If the NP or PA is prescribing at least put their freaking name on the bottle with the supervising physician.

I REALLY, REALLY wish there was a national system because it really is confusing. I can write prescriptions in Mass and Texas, but can't in Colorado without 1800 hours, and CA after 6 months of hours... etc..

If a person is certified and has a DEA, they should be allowed to write scripts in every state!

okay, so see how simple it all is???

to answer your question, usually the Doc will just give you a pad with his name, etc.. OR easier you will just call the pharmacy under his name. Once the pharmacy has his info you don't have to repeat it every time. Sometimes the doc will just sign his name on all the sheets of a pad. Guess it all depends if the Doc trusts you or not. i haven't had any issues. Just find a job where they've had NPs before and they will know how they like to handle it.