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There is a scenario according to which one nurse notices how another nurse practitioner writes a prescription for a narcotic for her husband, who is not a patient of this nurse. It is necessary to decide if the former nurse has to report on the latter nurse in this situation regarding the existing legal and ethical considerations. Drug Enforcement Administration (2017) defines a nurse as a mid-level practitioner who is permitted by the United States to dispense a controlled substance in the course of professional practice (para. 38).
However, each state has its own peculiarities concerning a prescribing process. For example, in New Jersey, an advanced practice nurse has the right to prescribe medications under appropriate settings, including the collaboration with a physician, a standing order, and mentioning all necessary information about the patient ( Senate, No. 1282 , 2016). Similar conditions are mentioned in the legislation in such states as Texas and Arkansas. In the case study under consideration, not much information is given about the awareness of a physician about this prescription. Therefore, it is legally inappropriate to report on this case.
Certain ethical and practical issues have to be taken into consideration. For example, there can be a lack of a clinical indication for prescribing a medication (Arcangelo & Wilbur, 2017). The nurse who prescribes the drug is aware of the main complaints of the patient and the specific issues of his health condition due to the fact that they are the closest relatives. Taking this fact into consideration, it is possible to say that the nurse does not break any ethical regulations from the point of view of the relations between a medical worker and a patient.
At the same time, a serious conversation should occur between the two nurses under analysis. It is necessary to remind the nurse who prescribes the narcotic about possible outcomes and changes in health. Besides, a pharmacist is responsible for drug disposal and may notice the same names of the patient and the nurse and pose some questions that may lead to additional investigations and new reports (Mistry, Santaniello, & Spooner, 2017). In general, in this situation, there are four stakeholders, including a nurse who notices, a nurse practitioner who writes a prescription, a patient, and a pharmacist who will be responsible for further implementation of a drug.
The consequences of this action depend on the state where this case occurs and the behavior of a pharmacist. For example, in New Jersey, a strict opioid prescribing law has been recently offered and approved (OShea, 2017). Opioid prescriptions are limited to 7 days or even less. Anyway, a nurse who notices this case is not responsible for reporting on this case. However, a pharmacist and a nurse with a prescription may be legally responsible in such a state as New Jersey.
To promote an ethically and legally appropriate decision making, two strategies may be used. Both strategies help to consider legal and ethical implications. First, it is possible to pay enough attention to patient education and explain what health threats and challenges can be observed as soon as the drug can be obtained (Arcangelo, Peterson, Reinhold, & Wilbur, 2017). Such a strategy should touch upon some aspects of the code of ethics for nurses and evaluate the peculiarities of the cases when nurses provide their beloved ones with care.
The patient has to be aware of the outcomes and make a final decision regarding the state and law. Another strategy is based on the state legislature and the conditions under which the nurse practice act may be approved and supported. However, regarding the scenario, not enough information is given to make final conclusions, and additional investigations are required to make a correctly final decision.
References
Arcangelo, V.P., & Wilbur, V. (2017). Issues for the practitioner in drug therapy. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4th ed.) (pp. 3-14). Ambler, PA: Lippincott Williams & Wilkins.
Arcangelo, V.P., Peterson, A.M., Reinhold, V., & Wilbur, V. (2017). Integrative approaches to pharmacotherapy A look at complex studies. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4th ed.) (pp. 1021-1036). Ambler, PA: Lippincott Williams & Wilkins.
Drug Enforcement Administration. (2017). Title 21 code of federal regulations. Web.
Mistry, S.K., Santaniello, B.I., & Spooner, J.J. (2017). The economics of pharmacotherapeutics. In V.P. Arcangelo, A.M. Peterson, V. Wilbur, & J.A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4th ed.) (pp. 1009-1018). Ambler, PA: Lippincott Williams & Wilkins.
OShea, T. (2017). New Jersey enacts strict opioid prescribing law. Pharmacy Times. Web.
Senate, No. 1282: State of New Jersey: 217th legislature. (2016). Web.
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