Prescriptive Authority Issue Among Nurses


The necessity to prescribe controlled substances and evaluate the outcomes of this responsibility remains an issue that is open for discussion in modern health care. Advanced practice registered nurses (APRNs) spend much time to receive their licenses and prove the correctness of this trust. However, there are situations when controlled substance registrations may be turned in. One of such cases happened to Heather Alfonso, an APRN at the Comprehensive Plan & Headache Treatment Center in Derby, who prescribed some narcotic pain medications to different patients, relying on the assistance of an unlicensed practitioner (Chedekel, 2015).

Some prescriptions were proved to be inappropriate and put patients under threat of serious addiction and abuse complications. The lack of control, poor experience, professional neglect, and even corruption are the issues about prescriptive authority among nurses; such solutions as high-level control by the Drug Control Division (DCD) or the Department of Public Health (DPH), established limitations on prescriptions, and quarterly or, at least, annual accreditation may be offered to avoid inappropriate situations.


Despite numerous attempts to control health care and pharmacological prescriptions in modern hospitals and centers, many nurses and other medical practitioners may be accused of inappropriate or ethically wrong behaviors and prescriptions. In some cases, APRNs make mistakes because of a lack of control. They do not think that their prescriptions and decisions can be traced and analyzed or that they may be punished. Although nurses understand their responsibilities and the possible adverse effects of their prescriptions, some decisions are hard to explain.

ARNPs have the right to prescribe and dispense amphetamines, hormones, or Schedule II. Still, the legislation does not address full authority to practice, and additional certificates are required to complete the functions of a healthcare provider (Sabo, Chesney, Tracy, & Sendelbach, 2017). Nurses spend their time applying for programs and evaluating their skills instead of gaining practice and experience. As a result of poor experiences and the inability to communicate with all patients, nurses make wrong or inappropriate recommendations and disregard their prescriptive authority of controlled substances. They neglect the need to control the effects of drugs among patients during the next 72 hours (Chedekel, 2015). The mistakes that some healthcare providers make may cost someone’s life.

Finally, it is not officially approved, but the cases of corruption can take place in healthcare facilities. Nurses accept gifts and rewards for their services from patients. The prescriptive authority should include the power of professionalism and respect for all patients with their needs and demands. To avoid unclear and doubtful situations, improved control is recommended. In many facilities, the DCD and the DPH begin their activities and checkups only when complaints or unpredictable changes occur.

Not much attention is paid to nurse activities, for example when they introduce reports with clear facts and standard achievements. To avoid difficulties, such measures as additional accreditations, clear limitations, and thorough control are required. It seems reasonable to read the reports where positive achievements and clear explanations are given instead of dealing with criticism.


ARNPs should understand that they can use their prescriptive authority in different ways, but all of them should be safe for people. Drugs may cause addiction and abuse, and nurses are responsible for any possible outcomes. Control, order, and reports should promote the high professionalism of nurses in their prescribing practice and the need to reduce complaints and cases similar to the one that occurred with Alfonso’s several years ago.


Chedekel, L. (2015). High-prescribing nurse surrenders drug licenses. Connecticut Health I-Team. Web.

Sabo, J. A., Chesney, M., Tracy, M. F., & Sendelbach, S. (2017). APRN consensus model implementation: The Minnesota experience. Journal of Nursing Regulation, 8(2), 10–16. Web.

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NursingBird. "Prescriptive Authority Issue Among Nurses." February 9, 2021.