is this within my scope?

[sweetieann]

Hi all:

So a tech that I work with gets the Depo provera shot as birth control. She asked if I could gie her her injection next time I see her. Am I legally able to do this?

Thanks!

[netglow, ASN, RN]

Well Shoot Scrubby, that just sucks something awful.

[canesdukegirl, BSN, RN]

Scrubby, that sucks big old donkey...gonads. Dang girl, I hate you had to go through that. OP...just another example of reasons to steer clear.

[Darknights]

I was surprised when reading about your laws over there and your scope of practice. You do have to be careful about anything you do off duty that can be said to be nursing related. And if you give advice about a diagnosis or medication you also run the risk of being reported for giving medical advice. Failing to tell someone to seek medical advice for a condition also puts you at risk.

[elkpark]

So is it different because it is an injection vs., for example, cleaning and dressing a wound? I just find it hard to believe that just doing an act that is something within the scope of nursing automatically establishes a nurse-patient relationship and therefore liability. I understand the giving medical advice to a a neighbor thing, but to say the neighbor kid is over playing with your kids and falls and scrapes a knee (very minor no blood) and you clean it and put a band-aid on it and it later gets infected, to say that because you're a nurse you can then be sued for negligence or malpractice seems ridiculous. There is no nurse-patient relationship there and to say it is created by helping would just encourage nurses to never help anyone outside of work, because not helping wouldn't establish that relationship.

I realize the laws don't always make sense, but this just seems extreme to me. I'm curious now and will have to try to find some time later to research it. Does anyone know of any authority addressing this?

There is no difference between giving an injection, cleaning/dressing a wound, or any other nursing-related activity (first aid, giving advice, etc.). If you are a licensed professional, you are accountable for your practice 24/7/365. There are "Good Samaritan" laws that are supposed to protect individuals, including healthcare professionals, who respond to an emergency situation, but there is no legal protection outside of true emergency situations (and the Good Samaritan laws aren't necessarily good protection).

"Malpractice" is a fairly complicated legal concept and there are several conditions that must be met for someone to be found guilty in court (but that doesn't mean people can't try to sue someone, even if they don't have a strong case). In the example you give, a child's scraped knee becoming infected, a nurse would not be legally liable unless s/he had done something that fell outside the usual range of what any careful, prudent nurse would do in the same situation. But the fact that you were not at work and it was a neighbor child you treated would not be any kind of legal protection.

I repeat -- if you choose to provide a nursing intervention/service/activity to someone, in any situation or circumstance, you are, legally, choosing to enter into a nurse-client relationship with that person, and you are no less legally accountable for your decisions and actions in that situation than you are for your decisions and actions when you are at work.

I'm surprised at how many nurses I encounter who don't understand the legal ramifications of nursing licensure and practice -- I guess this is yet another of the many things that aren't being taught in nursing programs any more. Entering any of the licensed professions isn't just a matter of being able to get a better job or make more money -- it's taking on a serious responsibility to the public.

[Sarah010101]

Heck, Pharmacists in my province can administer them.

Really??? Pharmacists here in BC can renew prescriptions without an actual doctors order... they have to follow a certain criteria, i have never heard of a pharmacist actually administer a medication (like an injection) to a patient before... cool :)

[Nolee_of_Araya]

How does the nurse-patient relationship apply to a spouse? I was giving daily Kineret injections to my husband for several months earlier this year, and I administered vancomycin via PICC to him for about 3 weeks in 2010. I am assuming the daily bandage changes are no big deal. I am an LPN in NY (haven't practiced in a few years.)