As a nurse practitioner

Select ONE of the scenarios below:
~ Scenario 1:
As a nurse practitioner, you prescribe medications for your patients. You make an error
when prescribing medication to a 5-year-old patient. Rather than dosing him
appropriately, you prescribe a dose suitable for an adult.
~ Scenario 2:
A friend calls and asks you to prescribe a medication for her. You have this autonomy, but
you don’t have your friend’s medical history. You write the prescription anyway.
~ Scenario 3:
You see another nurse practitioner writing a prescription for her husband who is not a
patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide
whether or not to report the incident.
~ Scenario 4:
During your lunch break at the hospital, you read a journal article on pharmacoeconomics.
You think of a couple of patients who have recently mentioned their financial difficulties.
You wonder if some of the expensive drugs you have prescribed are sufficiently managing
the patients’ health conditions and improving their quality of life.

To prepare:
*Review articles from the American Nurses Association, Anderson and Townsend, the
Drug Enforcement Administration, and Philipsend and Soeken.

  • Consider the ethical and legal implications of the scenario for all stakeholders involved
    such as the prescriber, pharmacist, patient, and the patient’s family.
  • Think about two strategies that you, as an advanced practice nurse, would use to guide
    your ethically and legally responsible decision-making in this scenario.
    ** Write an explanation of the ethical and legal implications of the scenario you selected on
    all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s
    family. Describe two strategies that you, as an advanced practice nurse, would use to guide
    your decision making in this scenario.
    ***Use current resources of within 5 years old.


Ethical and Legal Implications of Prescribing Drugs

After a nurse practitioner prescribes an adult’s dose to a five year old patient, there are
legal and ethical implications that face all the stakeholders involved in the scenario including the
patient’s family, patient, pharmacist, and prescriber. Considering that the patient’s age is tender,
the family should be informed about the case. Failure to disclose such information violates
ethical principles and this can never be justified. Reporting the issue to the relevant authorities in
the hospital and the family ensures that the dose or medication is changed before any detrimental
complications result (Cook & Hoas, 2009). The prescriber should admit and ensure the correct
thing is done since if nothing is disclosed and it is realized that the wrong medication was given
after there are complications, both the prescriber and pharmacist will be accountable ethically
and legally. The pharmacist is guilty since after a prescription is presented to him, he should at
least check the age and condition for which medication is being given.
The advanced practice nurse can use a number of decision-making strategies in such as
scenario. Medical errors are unfortunate but they always occur. The respect for autonomy
principle directs the practitioner to disclose errors to the family and patient as the patients get an
insight on what is taking place (Cook & Hoas, 2009). The patient becomes a participant in his
medical care, informed consent process becomes possible, and it reduces the linked
psychological distress and concern the family might have. According to the beneficence
principle, practitioners are entreated to offer benefits to patients by disclosing errors regardless of
whether he will risk loss of reputation, privileges, and finances (Cook & Hoas, 2009).



Cook, A. F., & Hoas, H. (2009). Ethics Conflicts in Rural Communities: recognizing and
disclosing medical errors.

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