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In my opinion, if medical assistants can't pass meds, then they shouldn't be counting them. MAs are allowed to do both at my facility. Can you point me to information that might clarify the policy or law on this?

Wednesday November 6, 2013
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Question:

Dear Nancy,

I work as a nurse practitioner in an urgent care facility, and. I only work with medical assistants. There is no physician on duty when I am there. My question is about counting narcotics. The current medication policy states an MA can't give narcotics. However, when a physician is on duty with them they are giving narcotics. I have been told when an NP is on duty, I need to give the narcotic. No problem.

There is no counting policy. We do not have a system that distributes meds. They are locked in a cabinet. Even though the MA can't give narcotics when I am there, they still count meds with me. There has been an issue because I have asked for an RN to count (which means someone has to come from another department). I have asked if there’s a law or regulation on who can count, but I am told this is just the way of the hospital. In my mind, if they can't give meds, they should not count them. Can you refer me to some websites or information that might help me. I have tried to look online, but can't find the correct sites.

Stacey



Dear Nancy responds:

Dear Stacey,

In order to get specific information on your practice as an NP and with whom you can count narcotics, you need to consult with a nurse attorney or attorney in your state who can advise you of what your nursing practice says about your NP practice and how it applies to this situation. However, generally, as you know, the counting of narcotics is routinely done by two licensed nurses, nurses who can administer narcotics. If two licensed nurses are not available, a licensed nurse and another licensed healthcare provider can count narcotics as well. The key is that the individuals counting are licensed and authorized by state and federal law, and a facility policy based on applicable laws, to do so.

It may be that a physician can delegate the administration of narcotics to an MA in your state, but that seems highly unusual. If it is possible, the MA has hopefully undergone a specific training course and been certified to do so. When unlicensed assistive personnel are granted the right to administer medications, narcotics are usually not included in the medications. They are often restricted to administering topical creams and certain oral medications, as examples.

The attorney for the urgent care center may also be able to provide you with the information you seek, but do remember that the attorney's client is the urgent care center and not you specifically. Although seeking this advice might be helpful in comparing it to what the attorney with whom you consult with says, remember that the attorney you select is representing you, so that is the advice to follow.

In preparation for meeting with an attorney of your choice, you might want to review what your professional association says on this point. The American Association of Nurse Practitioners (www.aanp.org ) has a wealth of position statements concerning NP practice. Just click on the "Publications" tab.

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.