Who prescribes for themselves or family

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I started this conversation with a group last week, and thought I would continue it here.

How many of you prescribe for yourself, or family or friends?

How long have you been practicing?

Specializes in Family Nurse Practitioner.

Another thought: what if the NP is in a rural area where they are the only provider around? Would their family have to drive miles away when ill in order to get a script/treatment?

I would advise being very careful with this. The whole "if I don't do it who will?" codependent nursing mantra will bite us in the butt with salary negotiations, nursing duties that are not prescriber duties and justifying practicing out of our scopes. It doesn't do us any favors in the professional realm, imo. I hear this all the time from FNPs prescribing inappropriate psych meds because it takes time to get a psych appointment.

If someone has a decent relationship with their PCP my thought is if its something that is such a slam dunk that you are prescribing sight unseen why wouldn't the PCP just call in a script?

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Specializes in Emergency, ICU.
I would advise being very careful with this. The whole "if I don't do it who will?" codependent nursing mantra will bite us in the butt with salary negotiations, nursing duties that are not prescriber duties and justifying practicing out of our scopes. It doesn't do us any favors in the professional realm, imo. I hear this all the time from FNPs prescribing inappropriate psych meds because it takes time to get a psych appointment.

If someone has a decent relationship with their PCP my thought is if its something that is such a slam dunk that you are prescribing sight unseen why wouldn't the PCP just call in a script?

Agreed. I meant in those situations where the prescriber is the only PCP around. Rare, but possible.

In a large city where I live, there are plenty of other providers around in order to avoid prescribing for family.

Now friends is another issue. I have many friends who plan to make me their PCP as soon as all my paperwork is ready to go and I don't see anything wrong with being their provider.

Sent from my iPhone -- blame all errors on spellcheck

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Specializes in Emergency, ICU.

By the way, this discussion prompted me to go ahead and read that long set of rules for health professions in my state in detail and nowhere does it say don't prescribe to family and friends. Not that other rules couldn't be used to discipline as there are plenty of vaguely worded moral clauses in the rules...

In my state, it would certainly boil down to the personal opinion of the board members.

Sent from my iPhone -- blame all errors on spellcheck

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Specializes in Family Nurse Practitioner.
By the way, this discussion prompted me to go ahead and read that long set of rules for health professions in my state in detail and nowhere does it say don't prescribe to family and friends. Not that other rules couldn't be used to discipline as there are plenty of vaguely worded moral clauses in the rules...

In my state, it would certainly boil down to the personal opinion of the board members.

Sent from my iPhone -- blame all errors on spellcheck

Excellent point and just me but before I did it for non-professional friends, family or myself I'd want it in writing from the BON that it was appropriate. I'm not about handing over my license for something I didn't even get paid for.

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Specializes in Family Nurse Practitioner.

From Carolyn Buppert:

Medscape: Medscape Access

Medscape: Medscape Access

I also know a physician who was suspended for a period of time for prescribing to self and his girlfriend. Quick google search from the Maryland physician's site. Not nursing but I model myself after physicians and it would make sense to me if they aren't allowed to do it we shouldn't be either:

Suspension for an additional period of a minimum ofone year. The Board suspended the physician for an additionalyear for violating the Consent Order of February 2,2011, and for admitting to using CDS and self-prescribingCDS. Date of Action: April 2, 2012

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Specializes in Outpatient Psychiatry.
Not that other rules couldn't be used to discipline as there are plenty of vaguely worded moral clauses in the rules...

I agree with this. My state's nurse board has a wall covering of vague, ambiguous phrases that they can tie to unprofessional conduct or some other ridiculousness. I think most nurse boards are overly strict and given too much authority with what they deem as "unprofessional" particularly when they penalize people for things that have no nexus with nursing. In the same state, a physician would almost have to rob the Federal Reserve, execute some refugees, snort a line of coke during middle school career day, and dance naked on the Capitol lawn before the medical board blinked an eye.

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Specializes in Emergency, ICU.

And I guess the difference is also in the manner of prescribing. I wouldn't just call in a prescription for any person I haven't assessed, no matter who they are. That's why if my friends want me to treat them, they have to be my patients and pay me 😉

For family, I foresee another NP who is a friend evaluating and prescribing for them. And I would do the same for them and their family members. It's more objective that way. I don't know that I could really "see" my family members as patients; I may miss something. There's comfort in not knowing the client personally.

Sent from my iPhone -- blame all errors on spellcheck

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Specializes in Family Nurse Practitioner.
I agree with this. My state's nurse board has a wall covering of vague, ambiguous phrases that they can tie to unprofessional conduct or some other ridiculousness. I think most nurse boards are overly strict and given too much authority with what they deem as "unprofessional" particularly when they penalize people for things that have no nexus with nursing. In the same state, a physician would almost have to rob the Federal Reserve, execute some refugees, snort a line of coke during middle school career day, and dance naked on the Capitol lawn before the medical board blinked an eye.

My state's BON is decidedly vague also but I have to say that while MDs only get suspended in most cases and get their licenses back quickly their governing body is quick to pull the trigger on foolishness.

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Specializes in Nephrology, Cardiology, ER, ICU.

I've been an APRN for 9 years and believe me, if someone wants to hang you and believe me, there are folks that look for things to complain about. This person that I referenced is someone who I know personally. She is a solid practitioner who prescribed a simple antibiotic for her son for an ear infection.

This is simply not a good practice.

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Specializes in Outpatient Psychiatry.
I've been an APRN for 9 years and believe me, if someone wants to hang you and believe me, there are folks that look for things to complain about. This person that I referenced is someone who I know personally. She is a solid practitioner who prescribed a simple antibiotic for her son for an ear infection.

This is simply not a good practice.

What's not good practice is to discipline a professional for doing exactly what they do everyday.

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I've been an APRN for 9 years and believe me, if someone wants to hang you and believe me, there are folks that look for things to complain about. This person that I referenced is someone who I know personally. She is a solid practitioner who prescribed a simple antibiotic for her son for an ear infection.

This is simply not a good practice.

Well, again I have to say "use common sense". It seems this case was really about the supervising physician not standing up for her in this case. Obviously, she examined her son and used due-diligence when deciding on prescribing the antibiotic.

But, what you have said certainly serves as a warning.

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From Carolyn Buppert:

Medscape: Medscape Access

Medscape: Medscape Access

I also know a physician who was suspended for a period of time for prescribing to self and his girlfriend. Quick google search from the Maryland physician's site. Not nursing but I model myself after physicians and it would make sense to me if they aren't allowed to do it we shouldn't be either:

Suspension for an additional period of a minimum ofone year. The Board suspended the physician for an additionalyear for violating the Consent Order of February 2,2011, and for admitting to using CDS and self-prescribingCDS. Date of Action: April 2, 2012

Yes, but in this case he was prescribing controlled substances to himself and his girlfriend. He was not real smart.

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