Question:
Dear Nancy,
What advice and parameters would you give an NP about the appropriateness of writing prescriptions for themselves, family members and friends? I will not do this, as I always have believed I must have an active chart to give an Rx. I see other NPs freely writing prescriptions without a medical record, and I wonder for my peers and myself whether I am being too conservative.
John
Nancy Brent replies:
Dear John,
The response to your question is best found in the state nurse practice act and rules. Sections to review would include the scope of practice of the NP and the grounds for discipline of the NP. As examples, the practice act may state that any advanced practice nurse, including an NP, may not exceed the prescriptive authority delineated in the collaborative agreement with the collaborating physician (if such an agreement is required in your state), or there may be a clear prohibition of prescribing medications, including narcotics, for one's self or one's family. If not contained specifically in the act or rules, prescribing for one's family or friends when not a patient being seen by the NP may be included under the general category of "unprofessional conduct.?
As you indicated, another problem with this practice is the requirement for APNs to establish and maintain patient care records as required by law. If an individual is prescribed a medication, he or she should be treated as a patient, with a medical record established and maintained for that individual. Simply prescribing medications for an individual, then, without an active medical record in existence, supports another potential violation of the act or rules.
You can check your state nurse practice act and rules by placing your state's name and then "nurse practice act" in your online search engine. The act and rules should be included in one of the search items. You also can check the act and rules by going to your state?s board of nursing's home page on the Internet.
If you need additional information about this practice, consulting with a nurse attorney or attorney in you state who works in the area of professional regulatory law would be most helpful, so you?ll have accurate and specific advice about your advanced practice role in this area.
Cordially,
Nancy
