It is not within the scope of practice of the licensed practical nurse to access the pharmacy after hours to obtain medication.
It is within the scope of practice of the appropriately prepared registered nurse in certain limited situations, to access the pharmacy during the pharmacist’s absence as provided for in the Mississippi Pharmacy Practice Regulations. Article XXIX, Section 4, Subsection C of the regulations states, “Whenever any drug is not available from floor supplies or other storage areas and such drug is required to treat the immediate needs of a patient whose health would otherwise be jeopardized (emphasis added), such drug may be obtained from the pharmacy in accordance with the requirements of this subsection. Only designated nurses in any one shift may be given access to the pharmacy and may remove drugs therefrom. Nurses allowed access to the pharmacy shall receive thorough education and training in the proper method of access, removal of drugs and records and procedures by the Director of Pharmacy, who shall require at a minimum the following:
- A. Drugs may be removed from the pharmacy only in an amount necessary to treat a patient’s immediate needs until the pharmacy is once again attended by a pharmacist;
- Removal of any drug from the pharmacy by an authorized nurse must be recorded on a suitable form showing patient name and room number, name, strength and amount of drug, date, time and signature of nurse;
- B. The completed form and a copy of the practitioner’s order shall be placed conspicuously so they will be found by a pharmacist and verified promptly;
C. The director or his pharmacist designee shall check and initial the order.” The dispensing of medication is outside of the scope of practice of the licensed nurse, unless the nurse is a registered nurse certified in advanced practice. The licensed nurse may administer the medications, once they have been appropriately prepared and labeled by the pharmacist, provided:
- The nurse is educated and competent in the procedure. This education and competence are documented initially and on an ongoing basis. (The nurse must be knowledgeable of all components related to administration of the medications ; i.e., indications and use, actions, dosages, contraindications, precautions, side effects, antidote, recommended monitoring and emergency resources/equipment, etc.);
- There is a medical order for the procedure;
- The procedure is reviewed periodically to assess changes in the patient’s condition;
- All necessary resources including, but not limited to, essential monitoring and emergency equipment, are available;
- The procedure is performed and the patient monitored according to accepted standards of practice; and
- The facility has policies and procedures in place regarding all aspects of the issue. The Board of Nursing does not maintain a listing of specific medications acceptable for administration by registered nurses and licensed practical nurses. When administering any medication, the nurse should be knowledgeable of and comply with all applicable state and federal laws, rules, regulations and guidelines pertaining to the specific medication including, but not limited to, those of the Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), the Mississippi Board of Pharmacy and the Board of Nursing.