Legal, Policy and Ethical Aspects of Prescribing - Essay Example

?Legal, Policy and Ethical Aspects of Prescribing As a profession and a practice, nursing is based on making of decision meant to save a life or improve the quality of life. Nurses are expected to make decisions such as which injection to give, how to take care of a patient, how to keep a patients private information and in some unfortunate times how to end a life. Nurses have to make appropriate prescription decisions and this requires a point of reference or guiding principles. Nursing practice has laws, ethics, and policies that guide their decision-making in relation to making prescriptions (Galea, & Vlahov, 2005). Are nursing laws, ethics, and policies solely sufficient in making medical prescriptions? This paper will therefore analyze nursing laws, ethics, and policies about prescription. The paper will also evaluate the significance of each factor in making of prescription by nurses. Just like any other practice or professional, nursing is subject to the law. The constitution is the supreme law of a country and this indicate that nursing practice is under the country’s constitution (Adams, 2004). This implies that a self-sufficient nurse needs to know the laws that pertain to prescription. A prescription nurse is also expected to have a good knowledge on over the counter medicine (OTC) and the implication of the concerning them (Graham, 1995). For instance, while administering OTC a nurse should ensure that the prescription order from the doctor matches with the label of dispensed medicine. The rightful user of the medicine should be identified. Correct dosage administered concerning age, body mass index, dosage form, symptoms among other factors. Correct timing should be done. Failure to adhere to one or several of these guidelines leads to legal or ethical implications. A nurse is expected to have knowledge of the statutory law that apply to prescription (Funigiello, 2005). Accurate or lawful prescription of drugs requires the knowledge of manufacturer’s guidance literature. Making prescriptions in accordance to this literature can protect prescription nurses from the consequences of the law following a complaint from a patient According to the law, misappropriate prescription can be judged as a criminal law or civil case under the law of torts (Bodenheimer, & Grumbach, 2005). Nurses have the obligation of patient education whereby supportive guidelines on the correct use of prescribed medication is given. The guidance or briefing should be accurate and should consider enlightening the user on potential dangers. The patient or user of the medication should be able to understand all the instruction. When the patient is suspected to be lacking in understanding of the information given, then their guardians should be briefed instead. This helps the nurse to avoid most torts, which may arise from wrongful prescription guidelines (Purtilo, 2005). It is also a requirement of the law that a patient’s medical and prescription information be held with confidentiality to avoid ethical issues. Although the laws provide the nurse with important guidelines in the nursing practice, the law is bound on internal hospital environment matter implying the need for more analytic principles. Nursing ethics are the accepted codes of conduct in the nursing profession, these codes of conduct provide nurses with important guidelines required during prescription. Nursing ethics are based on human conscience that is based on accepted wrongs and rights (Borkowski, 2005). A nurse is therefore expected to make prescription decisions based on the expected outcome of a patient. The committee of safety on medicine (CSM) provide guidelines to nurses that fit well as nursing ethics. Most of the times, cases of disability, mental health complications, critical illnesses and age of patients will demand careful approach especially at times of emergency. Nurses should act at the best interest of the patient whilst following legal and ethical guidelines at the same time. Nursing ethics also provide practising nurse with the scope of their duties in making prescription. The nursing ethics will therefore provide nurses with limits on their prescription duties. In their daily practice, nurses are faced with ethical dilemmas in making of prescription due to patients/clients demands and requirements. Issues of the best care to offer to patients and other related dilemmas are common experiences in the practice (West, 2007). In such cases, nursing ethics stand out as the most appropriate tool for decision-making. In order to make an appropriate ethical decision a nurse will require knowledge of ANA codes, nursing ethical principles and ethics of patient care. Nursing ethics acts as a measure of credibility of nurses in their practice (Milstead & Furlong, 2006). The yellow card reporting system is aimed at enabling nurses to report any cases of medical complications arising from medication. The nurses have an ethical mandate to report any cases of adverse drug reaction to the relevant healthcare institutions. This helps keep the population safe from potentially harmful drugs. Nurses have to determine the benefits of a decision after analysing its consequence. The Botox prescription controversy is an example of dilemmas that nurses go through in their daily decision-making. Nurses have to overlook the negative effects caused by the drug based on its curative benefits and this raise a controversy. Divalproex and Propranolol prescriptions are other examples of controversial prescriptions. Propranolol prescriptions should be administered carefully since Propranolol is open to abuse by otherwise healthy people. Its use during pregnancy can cause medical complications. Therefore, utmost care must be observed while prescribing such types of medication. Recently the prescribing powers of a nurse have increased and it covers the knowledge of the entire medical formulary (Lomas, 2009). Lomas continues to state that nurses still have difficulties in making prescriptions due the barriers facing them. Applying nursing policies enable nurses to overcome problems experienced in making prescriptions. Although prescription of medication is the responsibility of doctors, sometimes nurses are forced to make prescription decisions. Nursing policies are therefore important in offering guidance to nurses in their prescription duties. The policies provide conditions on when nurses should make prescriptions and their boundaries in the making of prescription. The nursing policies identify the emergency department as one of the area where making of prescriptions by nurses is feasible (Lomas, 2009). Medical accidents do occur in the process of making such decisions and in most cases, the nurse is held accountable implying the need of additional principals. This implies that nursing policies are not sufficient in making medical prescription by nurses. Conclusion Nurses make crucial and important decision in their practice that requires guidelines and principals. To eliminate the controversy involved in the making of prescription decisions, nurses rely on nursing policies, ethics, and laws. Although each factor is important, in the decision making process none of them is self-sufficient and therefore nurses will need an appropriate combination of the three factors according to their needs and requirements. An effective nurse must therefore adhere to prescription laws, policies and exercise high degree of integrity in the nursing profession especially during prescriptions to avoid issues of ethical concern. References Adams. J., 2004. Ethical issues in independent and supplementary prescribing in Courtenay and Griffiths (Eds) Independent and Supplementary Prescribing: An Essential Guide. Greenwich Medical Media. Chapter 5, pp 47-60 Bodenheimer, T., & Grumbach, K., 2005. Understanding health policy: A clinical approach (4th Ed.). New York: London: Lange Medical/McGraw-Hill. Borkowski, N., 2005. Organizational behavior in health care. Sudbury, Mass: Jones and Bartlett Publishers Funigiello, P. J.,2005. Chronic politics: Health care security from FDR to George W. bush. Lawrence, Kan: University Press of Kansas. Galea, S., & Vlahov, D., 2005. Handbook of urban health: Populations, methods, and practice. New York: Springer. Bartlett Publishers. Graham, N. O., 1995. Quality in health care: Theory, application, and evolution. Gaithersburg, Md: Aspen Publishers. Lomas, C., 2009. Nurse prescribing: The next steps. Nursing Time. [viewd January 26, 2011] Milstead, J. A., & Furlong, E., 2006. Handbook of nursing leadership: creative skills for a culture of safety. Sundbury: Jones and Bartlett. Purtilo, R., 2005. Ethical dimensions in the health professions (fourth edition). Philadelphia: Elsevier Saunders. West. J., 2007. Legislation, Regulation and Accountability in Prescribing In: McKinnon. J (Ed) Towards Prescribing Practice. Chichester. John Wiley and Sons. Chapter 8, pp167 – 194    Read More