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Dr. Abby
Dr. Abby, US Board Certified MD
Category: Medical
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Experience:  Family Physician practicing medicine for over 10 years, United States
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I am doing a case study and am unclear on a couple of points.

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I am doing a case study and am unclear on a couple of points. I hope you can help me. I will try to keep this brief:
Jerry McCall, Dr. Williams’s LPN and office assistant, is alone in the office at lunchtime, handling all the phone calls while the receptionist is out of the office. He receives a call from one of the doctor’s patients who requests a prescription refill for Valium, an antidepressant medication. The patient states that he is leaving for the airport in thirty minutes, that Dr. Williams is a personal friend, and that the doctor always gives him a small supply of Valium when he has to fly. He asks Jerry to call a refill order for Valium into the pharmacy “right away”.
If I am correct, first, an LPN cannot take verbal physician's orders nor can they call them in the the pharmacy. Second, if I am right, a Valium order only has a certain number of legal refills. They would already be on computer at the pharmacy. The patient would only need to go to the pharmacy to obtain a refill. If there were no more refills, then the order would be considered to be discontinued. A physician would have to write or call in a whole new order. So whether an LPN, medical assistant, or RN, it wouldn't matter; there would be no order to refill at all. Again, if I am right, it wouldn't matter whether we were talking about a benzodiazepine, an antihypertensive, or a prescription laxative, the law is the same regardless. And last, I have read that an LPN can verbally call in an order in emergencies only; I am assuming that an order for Valium to ensure a calmer plane flight would not qualify as an emergency. Am I right? I have searched online at length to try to find something that verifies that I have my facts right, but so far I am chasing my tail... anything you can verify for me, or if you have a source you can suggest that I haven't thought of, I would surely appreciate it.
Submitted: 5 years ago.
Category: Medical
Expert:  Dr. Abby replied 5 years ago.

LPN's can perform the duty of phoning in prescriptions.
However, the prescription first has to be signed off on by the physician.
So, Dr. Williams would need to authorize a refill or a new prescription of Jerry's Valium.
The LPN cannot do anything without speaking with Dr Williams first.
This order for Valium is not an emergency nor is there a situation I can think of where an LPN could prescribe a medication without a doctor's knowledge or authorization.

Feel free to ask any follow up questions,

Dr Abby

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