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As an RN at a local university health center, am I allowed to dispense medications?

Monday July 16, 2012
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Question:

Dear Nancy,

I am an RN at a local university health center. We are being asked to dispense medications, a bottle of PCN or Bactrim for strep tests — per protocol and signed by the medical director — or urine dips for urinary tract infections. Are we able to dispense medications this way? I have tried to get answers from the state nursing board, to no avail. Apparently, it is a very gray area to define “administer” versus “dispense.”

Suri



Nancy Brent replies:

Dear Suri,

The terms “dispense” and “administer” are often confused with each other. At the onset, it is important to know that a nurse's legal scope of practice includes "administering" medications, not dispensing them, unless the nurse is also an APN. Other authorized prescribers, can dispense medications as well.

Perhaps a clear way of differentiating the two terms is this. Dispensing is done by a pharmacist who mixes, bottles and labels medications that are prescribed by a healthcare provider authorized to do so. Administering a medication is physically giving the medication to the patient or person to take at that moment.

It is assumed that when you provide a student with whatever medication the protocol calls for, it has been bottled and labeled in some way, not by you, but by a pharmacist somewhere (e.g., on campus, or at the local pharmacy where the medications are purchased by the school). While the student will take the medication for a period of days, and not all of it immediately or at the moment, that protocol was written by a person authorized to do so.

It is unfortunate that your state nursing board has not provided you with more guidance about this issue. I assume your nurse practice act or its rules have not been much help to you either.

You might want to check with colleagues in other school health clinics to determine how they are managing this particular issue. Another resource is to get input on the pharmacy act in your state and what its definition of "dispensing" is. Perhaps the school's legal counsel would be another source of information on this issue.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.