The work of a nurse, regardless of degree and credentials, is associated with high responsibility to patients, the institution, and the staff. Since the work is constantly high-load, multi-level, and involves a large number of employees, it can sometimes be challenging to comply with such responsibility. One of these responsibilities of the nurse is refilling medicines, violations of which can lead to severe consequences. Therefore, it is essential to understand the credentials and accountability in case of breach of the procedure during refilling medicines.
The resolution of the situation presented in the case study most likely depends on the state where the incident occurs. Different states provide various levels of responsibility and penalties for actions beyond the scope of authority and the intruder’s superiors. In most states, physicians, employers, or supervisors are responsible for managing medical assistants (MA) and ensuring that they operate within their practice and standard of care. If MA acts carelessly or incompetently, it is unlikely that a nurse practitioner (NP) working at a facility will be responsible for the medical assistant’s actions. However, if the nurse practitioner has a number of supervisory responsibilities, then the incident is likely to have consequences for NP as well.
For example, in California, physicians should carefully view the decision to permit medical assistants to conduct refilling. The authority to prescribe refill prescriptions is only given to licensed physicians, podiatrists, surgeons, or individuals authorized by law (McLain, 2018). Medical assistants do not have the medical and pharmacological practicum, the license, or the legal authority to evaluate the appropriateness of a medication prescription or refill. Therefore, medical assistants may NOT refill medications. This means that the NP could not issue such a right to the MA, respectively, it is not her fault for what happened. Just as responsibilities may vary from state to state, they may also vary from facility to facility.
However, not all states have a policy on medical assistants and their limitation of authority to participate in drug refills. The American Association of Medical Examiners remarks that MAs play a vital role in ordering or restocking medicines. The medical assistants may accept verbal orders from the supervising, delegating, or managing physician unless such an order requires the MA to exercise “independent professional judgment” in executing the orders. If the incident took place in one of those states, for example, in Mississippi, NP might be liable or will have to prove that MA committed the act on her own, without her knowledge and consent.
The outcome of this situation will also depend on if the nurse practitioner’s practice was full, reduced, or restricted practice authority. If NP has full practice, this may imply supervisory duties. In this case, the nurse practitioner is responsible for monitoring the medical assistant and ensuring that MA is acting within the area of practice and the pinnacle of care. Because medical assistants are unlicensed health professionals, they must work under the control of a superior, who may be an NP. Before starting to work with supervised MAs, it is essential that NPs contact the state’s medical and nursing board to learn about the options for such a collaboration. Rules and laws may vary by state as each has its features. Some states allow licensed nurses and doctors to sign a supervisory duty agreement. There are states where doctors are the only professionals allowed to supervise unlicensed professionals, such as medical assistants.
References
Brent, J. N. (2018) Can RNs/CMAs without prescriptive authority process refills? Nurse.
McLain, A. (2018) May medical assistants call in new prescriptions or refills to a pharmacy? Cooperative of American Physicians.