The case scenario depicts a situation where I make an error as an NP when prescribing medication to a 5-year-old male patient. Instead of dosing the patient appropriately, I prescribe a dose suitable for an adult. This paper seeks to explore the ethical and legal implications in this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.

The case scenario depicts a situation where I make an error as an NP when prescribing medication to a 5-year-old male patient. Instead of dosing the patient appropriately, I prescribe a dose suitable for an adult. This paper seeks to explore the ethical and legal implications in this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.

As Nurse practitioner (NP), before prescribing medication to patients, it is the NP responsibility to gather data by taking thorough health history and performing physical examination. Doing this the NP will be able to properly diagnosis patient and provide correct treatment plan. Base on the federal law and regulations NP’s  are allowed to prescribe, dispense, or administer any schedule II, III, IV, or V narcotic medication, which includes methadone for pain management if the treatment is medically necessary and the pain believe to be real (Drug Enforcement Admnistration (n.d)).  Prescribing narcotics for friends or family members or for self are illegal, knowing your state rules and regulation is important. Each practitioner is responsible for knowing the law and regulations in the state of practice. Some states require physician signature on all prescriptions; other states on require physician signature on only controlled substance (Arcangelo and Peterson, 2013).  In the state on Texas where I live, NP practice in collaboration with physician to ensure consultant-referral type relationship (Arcangelo and Peterson, 2013).

Strategies to address disclosure and nondisclosure

In the above case scenario, reporting this issue will be the best route but the complication behind it will be the fear of losing one’s job or position NP as a whistle blower. A whistleblower is anyone who has and reports insider knowledge of illegal activities occurring in an organization ( Kenton, 2018).  I may suffer retaliation and uncomfortable when continuing to work with the individual. Before reporting the individual NP, I will first talk to her about her action of writing narcotic prescription for family member and the risk. NURS 6521 Assignment: Ethical and Legal Implications of Prescribing Drugs.

Stakeholders Involved

Looking at the above case scenario, the stakeholder involved are: the nurse practitioner herself, the pharmacist, the physician she’s working with, and the spouse who is the patient in this case. The practitioners faces ethical and legal pressures when it comes to prescribing medications, the NP should consider the pro and cons of prescribing medication like narcotic for her spouse and also examine if this act of practice aligns with the rules and regulation of the state she is practicing.  This NP act also put the license of the physician that she is working under at risk. Finally, the pharmacist’s responsibility when the medication is picked up at the pharmacy is to educate the patient the use of the prescribed medication and the contraindications.

                                            Strategies involved making my decision

In the healthcare professions, nurses face ethical situation most of the time when trying to do the right thing for the best outcome. First, when prescribing medications to patient it is important to do a thorough assessment, good data collection, education, and good communication. Secondly, it is important to know the law and regulations of the state you are practicing. In the state of Texas, NP’s are  require to register with the U.S Drug Enforcement Agency (DEA) before prescribing controlled substances. They also have prescription monitoring program (PMP). NP in Texas operate under restricted practice conditions and must have and agreement with collaborating physician in order to prescribe controlled substances (Coalition for Nurses in Advance Practice, 2018).

The process of writing prescriptions and strategies to minimize medication errors

The NP need to evaluate and identify the patient’s problem to properly diagnose the patient. The first line of therapy will be to review the pathophysiology of the disease, then select the appropriate medication needed to be prescribed.

When prescribing medications, the NP is responsible for identifying the patient medication allergies and the type of reactions. NURS 6521 Assignment: Ethical and Legal Implications of Prescribing Drugs. The provider should be able to calculate dose correctly, be aware of sound alike or look alike drugs, remember the 5 R’s when prescribing. Taking all this extra precautions will help to prevent medication errors and adverse effects.

References

Arcangelo, V. P. & Peterson, A. M.(Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: LippincottWilliams & Wilkins.

Drug Enforcement Admnistration.(n.d). Code of federal regulations.Retrieved June 7, 2017, from htt