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When Can a Nurse Write a Prescription?

Nurses are highly trained medical professionals who provide a broad range of services to patients from pediatrics to surgery, psychotherapy to general practice, nurses are the backbone of every health care field and specialty.

Nurse practitioners can prescribe medications in all 50 states. However, the degree of independence with which they can do so – and which classification of drugs they can legally prescribe – varies from state to state. In Illinois, someone who is licensed by the Illinois Department of Financial and Professional Regulation (IDFPR) as an advanced practice nurse (APN) has the authority to prescribe medications to their patients without a doctor’s oversight. Advanced practice nurses include titles such as a certified nurse practitioner (CNP), certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), or clinical nurse specialist (CNS). As a rule, a nurse holding one of these credentials can independently prescribe drugs listed as schedule 3 or above.

However, IDFPR limits an APN’s ability to prescribe some schedule 3 drugs, requiring in some cases delegated authority from a supervising physician. What is more, to be able to prescribe or administer schedule 2 drugs in Illinois, even acting under a physician’s orders, an APN must complete a minimum of 45 hours of graduate education in pharmacology and 5 hours of continuing education annually (225 ILCS 65). APN’s must obtain a specialized degree from an approved nursing program and typically has a graduate degree as well and must also pass a state examination.

By comparison, registered nurses are not allowed to prescribe medications independently. For registered nurses, a physician order is always required to prescribe controlled substances. While an RN is often asked to prepare patient medical histories, record symptoms, monitor patient recovery, and assist with medical treatments, RNs are not allowed to diagnose patients, write treatment plans, or prescribe medications.

However, there are a few exceptions that allow nurses of all types to act more independently. In an emergency, an RN may be permitted to administer certain medications by his or her employer. Outside of work, nurses can also administer medications and are typically protected from liability under the Good Samaritan laws on the books in every state.

Today, an increasing number of health care facilities have implemented standing orders for nurses, which allows them to provide certain medications to patients without a direct order from a physician. These orders are usually precise, spelling out what nurses can do under certain circumstances with a particular type of patient. In this way, some health care facilities give their nurses more leeway in prescribing medications while still protecting them from potential liability. But unless you are an APN, the best way to avoid the appearance of practicing without a proper license is to follow all standing orders and facility policies concerning medications.

The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact an attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with an attorney licensed to practice in your jurisdiction.



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