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Legal Responsibilities in Drug Administration

Nurses and Drug Prescriptions.
Registered and licensed practical nurses are legally empowered, under state nurse practice acts, to give medications ordered by licensed physicians and dentists. In some states, nurse practitioners may prescribe medications.

When giving medications, the nurse is legally responsible for safe and accurate administration. This means the nurse may be held liable for not giving a drug or for giving a wrong drug or a wrong dose. In addition, the nurse is expected to have sufficient drug knowledge to recognize and question erroneous orders. If, after questioning the prescriber and seeking information from other authoritative sources, the nurse considers that giving a drug is unsafe, the nurse must refuse to give the drug. The fact that a physician wrote an erroneous order does not excuse the nurse from legal liability if he or she carries out that order.

The nurse also is legally responsible for actions delegated to people who are inadequately prepared for or legally barred from administering medications (such as nursing assistants). However, certified medical assistants (CMAs) administer medications in physicians’ offices and certified medication aides (nursing assistants with a short course of training, also called CMAs,) often administer medications in long-term care facilities.

The nurse who consistently follows safe practices in giving medications does not need to be excessively concerned about legal liability.
Legal responsibilities in other aspects of drug therapy are less tangible and clear-cut. However, in general, nurses are expected to monitor clients’ responses to drug therapy (eg, therapeutic and adverse effects) and to teach clients safe and effective self-administration of drugs when indicated.
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