Prescription drugs have become a part of daily life for millions of individuals.
Yet, what they might not realize is that only certain medical professionals have the ability to write prescriptions for these medications.
We’ll highlight which nurses can prescribe these drugs, as well as the various laws for writing these prescriptions.
So, can a nurse write prescriptions? No, registered nurse (RN) cannot write prescriptions. A licensed practical nurse (LPN, LVN) also cannot write prescriptions. The exceptions to this would be advanced practice nurses (APRN) who can write prescriptions, but it varies per state.
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The Importance of Prescriptions
Prescription drugs are one of the primary medical advancements that millions of people use on a daily basis.
These medications help nurses and doctors diagnose illnesses, prevent diseases, treat symptoms, and in some cases, cure illnesses or conditions.
Prescription drugs can come in the form of pills, capsules, tablets, syrups, shots, patches, implants, nasal sprays, and more.
Even though they are prescribed by a medical professional, they can still be dangerous if used incorrectly.
That’s why proper procedures and regulations are put in place for nurses. In fact, not all nurses can even prescribe medications, and some need a physician’s permission to do so.
It Depends on the Nurse
The word nurse is simply an umbrella term. In fact, there are different types of nurses, and they each have their own protocol and duties that they are permitted to carry out (source).
When most people use the word nurse, they are referring to a registered nurse or RN.
Registered nurses have most likely completed a bachelor’s degree in nursing science, and they have passed the Board exam to receive their nursing license.
A registered nurse is typically seen working as a team player along with doctors and other specialty care nurses.
RNs perform basic nursing responsibilities, such as checking vitals, administering medications, consulting medical records, and educating patients.
RNs can work in assisted living facilities, clinics, home care, hospitals, schools, and more.
On the other hand, a nurse practitioner, or NP, has a higher level of education, and they can provide higher levels of care for patients.
This is an important distinction to make. Most nurse practitioners have a graduate degree in nursing, and they might also have certification in specialty care, such as trauma, emergency, or pediatrics.
This experience and education grants nurse practitioners the ability to work independently in a healthcare setting, usually as a primary care provider or a specialist.
NPs can perform the functions of an RN, but they can also prescribe medications for patients. In addition, they can order exams and X-rays, make diagnoses, and counsel patients.
So, remember that RNs and LPNs/LVNs cannot prescribe medications, but NPs can.
Part of an NPs education and training involves how to properly diagnose a patient, assess their symptoms, and make a suitable prescription recommendation.
They complete simulations during their schooling to better understand pharmacotherapy, or how to use prescription drugs to treat individuals.
They learn how to monitor the usage and safety of the patient taking these medications to obtain the smallest margin of error.
When would a nurse practitioner prescribe medication for a patient?
There are plenty of examples of when an NP would write out a prescription, too many to list here.
Even so, some common examples include if a patient needs antibiotics for an infection, or if the nurse believes that the patient would benefit from an antidepressant.
Other examples include birth control or a medication for COPD, such as Symbicort or Advair.
Writing Prescriptions for Controlled Substances
Nurse practitioners may write prescriptions for some controlled substances. The only exception is Alabama and Florida.
Controlled substances are grouped into categories called schedules, which range from Schedule I to Schedule V (source).
Schedule I medications carry the highest risk for substance abuse, and therefore as more restricted.
In fact, the DEA (Drug Enforcement Administration) doesn’t even consider Schedule I drugs suitable for medical use.
Schedule V drugs are those like codeine for coughs and phenylephrine for decongestants.
As you’ll see, different states have their own laws about which drugs a nurse practitioner may prescribe.
Sometimes an NP may have the freedom to prescribe medication independently, but other times he or she may need to consult with a physician first.
A Schedule II drug, such as Adderall for ADHD, may be prescribed by an NP in Arizona, but in Alaska, that NP would need to get the okay from a physician before prescribing the Adderall.
Laws Vary by State
Obviously, the freedom with which a nurse practitioner can prescribe medication will vary depending on the state they are working in.
It’s critical that nurses understand their own scope of practice as well as any medications that they are allowed to prescribe.
A highly debatable topic in recent years has been medical marijuana, and this is a good example of nurse practitioner prescription regulations (source).
Some states allow NPs to prescribe medical marijuana, which is a Schedule I drug, to patients.
Other states have not legalized marijuana at all, and still other states have legalized the drug for both medical and recreational use.
One of the responsibilities of any nurse is to fully comprehend the rules and regulations in their own state so that they can properly prescribe medications for their patients.
They should also fully understand their own scope of practice, whether they’re a physician, NP, RN, or any other healthcare professional.
Who Can Advanced Practice Nurses Write Prescriptions For?
When a nurse practitioner is thinking about prescribing a medication for a patient, they need to consider a few things before they go ahead with it.
Nurses are trained to consider things like the individual’s medical history, the proper diagnosis, the timing and dosage, and how the drug is taken by the patient (pill, syrup, etc.).
They also need to explain the medication to the patient, describing its intended use, how to take it, the proper dosage, how long they will be prescribed the medication, and any warnings or side effects that pertain to the drug.
In short, there is a lot to think about before jumping right into writing a prescription.
You might be wondering if nurses can write prescriptions for their own friends and family members.
Surely this has been done before, right? Well, once again, the laws for this will vary depending on the state.
Some states will allow a nurse practitioner to prescribe a drug to a family member for emergencies only.
Furthermore, the nurse needs to write out the prescription thoroughly so that it can be documented.
There is no handing off a pill or nasal spray to a friend in need. For controlled substances, there needs to be a genuine patient-provider relationship between the two people.
They can’t simply be friends or relatives, but instead patient and nurse or physician.
Keep in mind that a nurse will be responsible for any negative interactions or side effects that their patient experiences.
So, what about self-prescribing? Some states have laws prohibiting self-prescription while others allow it in certain circumstances.
Regardless, it always poses some ethical issues and a conflict of interest. It’s always best to have someone else prescribe your medications for you.
If there’s one thing that you remember, let it be this: a general nurse, or RN or LPN/LVN, cannot write a script for a prescription drug.
If you notice that an RN at your physician’s office is doing this, be aware that this is against the law.
Even getting verbal or written permission from the doctor to write the script does not grant an RN the authority to do so.