I'm an RN who's also certified to perform acupuncture. Recently, a patient who was advised to have surgery wanted to know about alternative treatments, including acupuncture, before deciding whether to consent to surgery. The surgeon didn't know enough about other such options to discuss them with her. Given my training, can I legally discuss how acupuncture might help the patient? - c.b., wash.

Congratulations on having the good sense to ask this question. In this situation, you must find out whether the surgeon would support your sharing the information with the patient and what your employer would think about you working outside the scope of your employment. As a nurse, you weren't hired to consult on acupuncture, so you wouldn't be covered by facility policy or procedure.

Years ago, a nurse in Idaho responded to a similar request by a patient. She relied on the American Nurses Association code of ethics, which supports nurses using all of their knowledge and skills to benefit their patients.* The patient's physician reported her to the Idaho Board of Nursing for interfering with the physician/patient relationship. The board terminated the nurse's license, and she wasn't vindicated until much later.

Keep in mind that even though ethical guidelines provide a standard of care, they don't have the weight of law behind them. Approach the surgeon about having a conversation with the patient. If he supports your educating her about acupuncture, document his approval and get written permission from hospital administration before you proceed. This is much safer for you and would help prevent the 8 years of litigation the Idaho nurse had to endure.

^*(Tuma v. Board of Nursing, 100 Idaho 74, 593. P.2d 711 [1979]). [Context Link]