Administration of Medication in Life Threatening Situations Without a Medical Order

In June 2004, the Board responded to an opinion request on the nurse administration of medication in life threatening situations without a medical order.

It was the advisory opinion of the Board that the administration of a legend medication without a valid prescription is not within the scope of nursing practice.  The statutes defining registered nursing practice and licensed practical nursing practice authorize the administration of medication as prescribed, but do not authorize the nurse to prescribe medication.

The Board recognizes that emergency situations will arise that require the administration of legend medications and the necessary medication may not be prescribed or the nurse may be unable to contact the patient’s medical provider for an order.  When this occurs, the nurse should immediately inform the nurse’s supervisor of the situation.  The facility’s medical director should also be contacted as needed.

In addition, health care facilities and medical providers should pre-plan for emergency situations.  Protocols can be established that provide for safe care, including the administration of medication in an emergency situation.  See Advisory Opinion Statement #14 Roles of Nurses in the Implementation of Patient Care Orders [PDF Format - 35k].