Cosmetic treatment & administration of S4 drugs by a nurse

Health Care Complaints Commission v Piper [2014] NSWCATOD 62 has a number of interesting aspects. The core of the complaint, which appears not to have been disputed by the nurse, is that a medical practitioner obtained  cosmetic injectable medications and provided them to the nurse, who charged a fee to patients to administer the drugs. She reimbursed the doctor for the cost of the drugs.

At [7] it was noted that a medical practitioner may supply an S4 drug to a nurse to administer to a patient if the patient is under the direct care of the medical practitioner and a specific patient authorisation to administer the drug has been given to the nurse. A medical practitioner may not supply an S4 drug to a nurse for administration to a patient who is not under the direct care of that medical practitioner. Further, a nurse may not administer any drug to a patient unless written authorisation has been given by a medical practitioner to administer the substance to that specific patient.

The remarks at [43] are of particular significance. The Tribunal recorded some sympathy for the nurse given the opportunities provided to her by the medical practitioner. It was highly critical of his acquisition and supply of the S4 medication for the nurse. There was said to be no doubt that he provided the means for her to engage in the conduct found to be unsatisfactory and professional misconduct.

However, this did not detract from the nurse’s responsibility to ensure she was complying with the law and with the terms of her registration to practise.

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