Prescribing a medicine, even with the professional competence and legal rights to do so, in this case, is a controversial issue requiring discussion. Without having a medical history of the patient and acting at a distance from the nurse, some implicit, automatic restrictions are required on which drugs should in no case be prescribed. The main nursing principle is not to harm the patient under any circumstances. It can be assumed that in the context of little knowledge about the situation with the patient, it seems weightier than the principle of patient autonomy, which implies their will crushing even over common sense. Every nurse faced with this professional and ethical dilemma should apply a so-called rational treatment plan.
Probably one of the most logical primary strategies may be to continue and maximize previous treatment in order to avoid accidental worsening of the situation, possessing incompatibility with unidentified biochemical elements in the patient’s body (Sabatino et al., 2017). In order to avoid mistakes that could have negative consequences, each nurse should consult the database of medicines proposed by the Institute for Safe Pharmaceutical Practices (Ladd et al., 2016). Their error-free summary of drugs and chemical compounds provides a sufficient basis for the competent and safe prescribing of drugs when needed.
Due to the risk of financial and legal liability, the nurse has two options. The first would be to completely refuse to prescribe the medicine without knowing the history of the disease, removing any responsibility except perhaps moral responsibility. The second option is to actually try to help prescribe the necessary medication that is dangerous to the practitioner if the patient is harmed. The State of Ohio divides financial claims related to misuse of medical practice (O.R.C. § 2323.43).
In the event of physical deformity of the plaintiff or major injury, the fine to the doctor can increase up to a million dollars, which is certainly an unacceptable risk. With an agreement not to disclose the prescribed treatment, however, it becomes possible to avoid liability in the event of a medical error. However, it seems that the nurse should inform the patient as fully as possible about their treatment status. Non-disclosure, in this case, violates the patient-oriented ethics of the doctor.
For example, taking on the responsibility of prescribing opioid analgesics for a patient with joint pain, the practitioner may not realize that he has had a hand in a massive problem. In the context of the modern plague of the opioid crisis, Ohio is one of the hotbeds of concern, where the legalization of the OTC sale of any opioid leads to an astronomical rise in its consumption. Taking into account such painful and problematic moments, a nurse has to select a medicine for the patient that would not constitute a problem in itself, regardless of compatibility with the patient’s body. The psychological and social presets of the patient are also unknown to the nurse, so even the slightest addictive drugs cannot be prescribed.
Of note is the number of opiate overdose-related deaths in the state since the implementation of the OTC sale of naloxone (Gangal et al., 2020). In this regard, it is necessary to prescribe painkillers to the patient with extreme caution and use a guideline specially developed for the state of Ohio (Penm et al., 2019).
Thus, it is required to take into account a multifaceted number of factors from different areas and disciplines in order to make an adequate decision for such a treatment appointment. The nurse must take into account the basic ethical principles of harmlessness, patient autonomy, and their family members’ personal concerns. Moreover, it is necessary to correlate the prescribed procedures with the laws in the patient’s state. This is important not only because of the possible violation of the legal field but also due to the fact that in some states, there is a drug epidemic that does not need another victim.
References
Gangal, N. S., Hincapie, A. L., and Jandorov, R. (2020). Association between a state law allowing pharmacists to dispense naloxone without prescription and naloxone dispensing rates. JAMA Network Open, 3(1). Web.
Ladd, E., and Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. Web.
Penm, J., MacKinnon, N., Connelly, C., Mashni, R., Lyons, M., Hooker, E. A., Winstanley, E. L., Carlton-Ford, S., Tolle, E., Boone, J., Koechlin, K., and Defiore-Hyrmer, J. (2019). Emergency physicians’ perception of barriers and facilitators for adopting an opioid prescribing guideline in Ohio: A qualitative interview study. The Journal of Emergency Medicine, 56(1), 15-22. Web.
Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., and Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association of NursePractitioners, 29(5), 248–254. Web.