Lucia was seen in an emergency room two days earlier for nausea, abdominal pain and vomiting. She was then seen at the outpatient mental health clinic by the psychiatric nurse practitioner, who worked under the supervision of the off site psychiatrist. The clinic received federal funding.
The psychiatric nurse practitioner was informed of the recent emergency room visit during the review of the intake paperwork completed by Lucia’s mother. The psychiatric nurse practitioner prescribed Zofran 4 mg by mouth every 4 hours prn for nausea and Prozac 40 mg by mouth every morning on a prescription pad which had been pre-signed by the supervising psychiatrist. The psychiatric nurse practitioner’s notes indicated that the Prozac was prescribed for depression, but an in depth screening and safety risk assessment was not documented.