Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.
Discussion Question:
What is your next logically sound course of action? Provide evidence to support your response.
Stephanie has been with the practice 10 years and feels confident she is knowledgeable enough to prescribe medications for certain illnesses due to her familiarity with patient care and commonly prescribed medications for certain illnesses, etc. However, she was not authorized to take Mrs. Smith’s prescription renewal request without Mrs. Smith being seen by the physician, myself, or another staff NP. The order for the prescription should have come from the physician, another NP on staff, or myself not an “insistent” patient who is not qualified to determine which illnesses are treatable with antibiotics or if she even needed an antibiotic. Even though my name is on the label as the prescriber, I am exempt from any liability due to my name being forged by Stephanie. According to the law, Stephanie’s actions must be reported to the authorities, which is the first step in clearing my name. Federal law states that prescription medications may only be written by licensed health care practitioners who have also received training in medication management and patient assessment (Singh et al., 2013). Each state has precise legal codes that require or permit health care providers to disclose a patient’s health information for the purposes of reporting a crime (Singh et al., 2013). The physician in charge has a legal and ethical responsibility to train employees about the laws that prohibit unauthorized persons from writing prescriptions. Stephanie has been at the practice so long that she has gotten comfortable with making decisions without consulting the physician or the NPs. Her actions are dangerous to the patient’s health, her career and those of her colleagues, and the future licensing of the practice. Any attempt to fill or write a forged prescription is a violation of federal statutes; the violating person is perpetrating a crime (Singh et al., 2013). I hate to be so dogmatic about it, but my license and professional reputation are at stake.
Numerous states have established laws that prosecute those who forge prescriptions (Singh et al., 2013). An example of such a law is the one posted below that was passed by the California legislature, which states prescription forgery is a violation of Business and Professions Code 4324 (Singh, 2013)
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