|Can unlicensed staff prepare/dispense prescriptions?|
Pharmacy/ Unlicensed Staff
Member Question: Is a receptionist, or an unlicensed staff person, able to prepare medications needed for a patient?
NYSVMS Legal Counsel: In a veterinary clinic or hospital, the veterinarian is really acting as a pharmacist, and most of the rules that apply to licensed pharmacists in a pharmacy should guide the dispensing of drugs in a veterinary practice.
The law and regulations for pharmacies have changed in the past several years, and unlicensed persons are allowed to have a greater role in filling prescriptions, so the standard for unlicensed persons in a veterinary practice can also be broadened from the guidelines we published several years ago.
My advice today is based on the additional duties that unlicensed pharmacy assistants can perform, and their limitations.
Consistent with those new rules, an unlicensed person in a veterinary practice can, acting on the written instructions
of the veterinarian:
• obtain a drug (provided it is not a controlled substance) from the stock kept in the veterinary practice;
• count out the dosage units specified in the medical record and/or the written instructions of the
veterinarian, and place them in an appropriate container;
• return the drug to the veterinary practice stock; and
• type out the prescription label and affix it to the container that will be delivered to the client/patient. All containers for prescription medications must be child-proof, as required by law; all labels must comply with the regulations that apply to pharmacies.
Controlled substances should only be handled by licensed persons authorized by the practice owner to have access to them.
When these activities are performed by an unlicensed person, the veterinarian must “review and approve” the drug prepared by the unlicensed person before it is handed to the patient, as a pharmacist must if they are being assisted by an unlicensed person.
The veterinarian or LVT must be the one to initial or otherwise record in the patient record the amount and strength of the drug dispensed. The veterinarian or LVT must be the person who counsels the client on the use of the drug, potential side effects, and any other relevant information, although the unlicensed person can physically hand the drug to the client.
In a pharmacy, a licensed pharmacist is permitted to have only two unlicensed individuals who work with them and perform these duties; the pharmacist must also provide the appropriate level of supervision over the unlicensed person performing these activities. My recommendation for veterinary medicine would be that a veterinarian using an unlicensed person must provide an appropriate level of training and supervision, which must include reviewing every prepared prescription medication before it is handed to the client by the unlicensed person.
Unlicensed individuals cannot “measure, weigh, compound or mix ingredients.”
Unlicensed individuals working in a veterinary practice are specifically allowed a limited role in giving medications to a patient. The Education Law provides that an unlicensed person may “provide supportive services to a veterinarian, including ... administering oral and topical medications, incidental to and/or concurrent with such veterinarian personally performing a service or procedure.” Although it is not specifically stated, I believe the law implies that the veterinarian should be present, or immediately available, if an unlicensed person is administering an oral or topical medication to an animal patient.
The regulations that outline the duties reserved to LVTs include among them “preparing and administering medications on medical orders of the supervising veterinarian.” This activity requires only general supervision by the veterinarian, a standard that is met if the veterinarian is readily available to communicate with the person they are supervising.