I work in a small community hospital where the RNs are expected to order tests before the patients are seen by a doctor. It is expected they order X-rays, CT scans and much more in triage. RNs order labs and meds verbally. Is this acceptable practice?
Nancy Brent replies:
As you are aware, your practice is governed by your state nurse practice act and its rules. Most likely, as an RN you cannot administer medications or order treatments and lab work without an order from a physician who has seen the patient. An exception to this general rule is when standing orders or protocols are developed by a physician for the nurse to follow when certain patient conditions present themselves.
Advanced practice nurses can order medications, order treatments and lab work based on their scope of practice as defined by the state nurse practice act.
It would be a good idea for you to bring your concerns to your chief nursing officer in order to determine if this practice is consistent with your act and rules. Also, a consultation with a nurse attorney or attorney who works with nurses and in regulatory law can help you obtain a specific answer to your concerns.