I'm an RN who's just started working in a radiology department. Here, the radiology technologists (RTs) can administer opioids for analgesia if they're under a radiologist's supervision. I thought only RNs and other licensed professionals can administer opioids. I can't find any written policy that gives RTs permission to administer these drugs, but our supervisor (who's an RT, not a nurse) says it's fine as long as the radiologist is overseeing things. Could I be held liable if an RT harmed a patient when I was the only RN working the same shift, even if the radiologist was officially supervising?-D.J., MICH.

Many states' medical practice laws allow physicians to delegate medical duties to persons they supervise. So what the radiologists in your unit are doing is most likely legal, but your role should be clarified for patient safety and your own peace of mind. Supervisory duties carry with them vicarious liability for any harm caused by the person being supervised, even if the supervisor has delegated care duties appropriately. If you're responsible for overall patient care, you could share liability if a patient is harmed because of an RT's negligence.

Discuss your concerns with your facility's chief nursing officer and the director of pharmacy. The facility should have a written policy that specifies the radiologist's supervisory responsibility for RTs and the nurses' responsibility in relation to the RTs. The policy should be consistent with generally accepted standards. For example, the American Registry of Radiologic Technologists has issued recommendations to define the role of RTs and the level of radiologist supervision expected for various tasks. You can access the document, Registered Radiologist Assistant Role Delineation, at http://www.arrt.org/radasst/finalraroledelineation.pdf.

If no policy is in place, request a written statement from the facility's legal counsel and risk manager. This statement should clarify that the physician, not the nurse, has assumed the responsibility to delegate certain duties to RTs and to supervise them. If your employer won't do this, you're best off getting a formal written opinion, upon which you can rely if the worst happens, from your state board of nursing and state attorney general.