Can a licensed nurse implement range orders?
The Board of Nursing has no guidelines prohibiting the appropriately prepared licensed nurse from implementing a drug order that has a dosage range. The medical provider makes the “medical judgment” as to the specific medication and dosage. The nurse is given the latitude to use “nursing judgment” in determining the amount to be administered based on the client’s clinical status. The nurse must apply adequate knowledge and skills in determining the dosage to be administered at any given time. Appropriate documentation of client assessment and evaluation must substantiate intervention. It is recommended that medication orders be patient/condition specific even if prescribed PRN. This would take away some of the notion of the nurse “prescribing” the medication. There should certainly be some consultation with the physician to initiate a standing order particularly if the signs/symptoms are deviations from the patient’s norm. Standing orders are certainly not to be used in lieu of medical
