Ethical and Legal Implications of Prescribing Drugs
In the selected scenario, the advanced practice nurse is prescribing expensive drugs, which is not ethically right. In the District of Columbia, Advanced practice nurses have the authority to prescribe medications for patients. Therefore the nurses are expected to ensure drugs are prescribed according to the standard ethical and legal requirements. Ethics are unwritten rules that guide morality during professional practice, while laws are registered and written down in the constitution. Ethically and legally, if the nurse is prescribing expensive drugs to the patients while there are cheaper options available, then that is wrong.
The government in the District of Columbia strives to make healthcare available at an affordable cost; therefore, opting to prescribe the expensive drugs is illegal (Mittal, Beletsky & Davidson, 2020). When the medications prescribed are costly, it causes medication error in some patients who find it costly. Medication error due to expensive medicine occurs when patients take lesser doses than recommended or even skip to take the doses at recommended times in attempts to save on the prescription they acquired expensively. In worse cases, some patients do not get the medication at all. With the errors, the prescribed drugs fail to achieve the intended purpose of improving the patient’s health status, and consequently, their quality of life is not getting better. The nurse risks losing her license, being withdrawn from duty, and even worse prosecution from affected patients and their families.
The prescription process entails a couple of stakeholders; the prescriber, the pharmacist, the patient, and the patient’s family. All of them are affected when deciding which drug to prescribe. The pharmacist and prescriber are expected to ensure that the patients and their families are comfortable with the drug cost. If the prescribed medicines are too expensive, then available options with equivalent treatment outcomes should be considered (Mittal, Beletsky & Davidson, 2020).
The error identified in the scenario should be disclosed even if it is not directly thought to be harmful, but it indirectly causes medication error and should be tackled. Disclosure for a nurse is the most ethical thing to do when they notice their practice is likely to endanger the lives of the patient, the patient’s families, and other involved professionals such as the pharmacist. During the disclosure, there are key strategies to use, such as; point out the error, explain to the concerned parties what transpired, own up sincerely and apologize, promising not to have a repeat incident. Then explanation is given to the patient on the way forward in attempts to correct the error (Mittal, Beletsky & Davidson, 2020). However, there are instances of non-disclosure practice, and they stem from situations where the nurse has to decide whether to share information. The option of non-disclosure is when the emotional trauma outweighs the benefits (Cwiek et al., 2018)
As an advanced nurse practitioner, some strategies guide the decision making and whether you should disclose the error. Nursing is a tasking profession, and every day in practice, one is faced with ethical dilemmas whether to come forth when mistakes like in this scenario happen. For nurses to make decisions, therefore they have to be rooted in a firm foundation morally to enable them to come forth. Two key strategies help the nurses decide to disclose errors, and are based on beneficence and justice. Nursing is driven by compassion, and therefore this prompts the nurse to feel bad when they err. Justice inspires the nurses to want to ensure that all patients receive quality and excellent services (Olsen, 2019).
Therefore, during the decision making, the nurse takes into consideration the consequences they are likely to face if other people identify their mistakes, and they have to terminate the prescriptions administered earlier on before proceeding to report the disclosure. The next strategy they apply is to analyze why they conducted the error, find the motive and source of the error, and then proceed to own up and sincerely desire to make up after the disclosure so that they free their conscience (Chan et al., 2019).
When writing prescriptions, some precautions should be taken to avoid medication error. A computerized name alert system to ensure that drugs are prescribed rightfully should be used, and at all times, a prescription guide should be available and accessible to the prescriber. The guide will help the prescriber to identify drugs that perform similar functions so that they consider the relatively affordable and effective choices to avoid errors like under-dosing from happening. The written prescription should be counterchecked for accuracy and reconciliation procedures also to ascertain that the correct dose, route, and time are selected for the diagnosed disease (Zimmerman & House, 2016). Proper documentation is essential to avoid mix-ups, and all the documents should be legible to avoid issuing wrong prescriptions.
In conclusion, in healthcare provision setting, nurses are prone to mistakes which can be ethical or legal. The District of Columbia works to ensure that all its citizens receive affordable healthcare, and therefore, prescribing expensive medications is likely to cause medication error. When a nurse errs in practice, disclosure is the most ethical thing to do to avoid a cascade of poor outcomes and better still to prevent the consequences patients are going to experience. The nurse must correct the motive that drove them to conduct themselves unethically and to stay rooted in the foundation strategies that drive the nursing profession.
References
Chan, T. E., Lockhart, J. S., Thomas, A., Kronk, R., & Schreiber, J. B. (2019). An integrative review of nurse practitioner practice and its relationship to the core competencies. Journal of Professional Nursing.
Cwiek, M., Kikano, G., Novaretti, M., & Klaus, J. (2018). International Implications of Open Disclosure of Medical Errors, and the Superiority of Full Risk Integration. Journal of Global Business and Technology, 14(2), 1-14.
Mittal, M. L., Beletsky, L., & Davidson, P. J. (2020). Ethical and Legal Considerations 24. Absolute Addiction Psychiatry Review: An Essential Board Exam Study Guide, 363.
Olsen, D. P. (2019). Ethical Considerations When Dismissing Patients for Noncompliance. AJN The American Journal of Nursing, 119(2), 64-66.
Zimmerman, D. M., & House, P. (2016). Medication safety: Simulation education for new RNs promises an excellent return on investment. Nursing Economics, 34(1), 49.