The scenario is that a colleague who is not a prescriber asks to have a pill prescription signed for a patient who needs a contraceptive pill. However, the dilemma is that the prescriber (me) has not seen the patient…
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Identify and discuss the legal, accountability and ethical issues for nurse prescribers raised by this request. I. Introduction (72 words) The scenario is that a colleague who is not a prescriber asks to have a pill prescription signed for a patient who needs a contraceptive pill. However, the dilemma is that the prescriber (me) has not seen the patient. Since prescribing medication without seeing the patient has many consequences, I try to discuss all the possible consequences of the situation. This is a critical application of accountability, law, and ethics in practice. II. Accountability (483 words) Prescribing should ideally be done only by people who are authorised to make prescriptions. “The Prescription Pricing Authorities in the UK require confirmation from the NMC of a registrant’s qualification to prescribe and the scope of their prescribing qualification” (“Standards of Proficiency for Nurse and Midwife Prescribers,” 2006, pp. 12). Not all nurse practitioners can make prescriptions and need to be qualified as under the regulations set out by NMC (2006). So prescribing by nurse practitioners is legal, but must be done with great care. After all, one must consider the effects a medication can have on a person. “The people in your care must be able to trust you with their health and well-being” (“The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives,” 2008, pp. 1). ). Not only that, but giving someone prescriptions for medicine is a task which requires much forethought as well as caution. Contraceptives have the potential to interact with negative side effects. “The administration of medicines….is not solely a mechanistic task to be performed in strict compliance with the written prescription of a medical practitioner (can now also be an independent…prescriber). It requires thought and the exercise of professional judgment...” (“Standards For Medicines Management,” 2008, pp. 1). This is why accountability is a key factor stemming from the necessity to get the prescription(s) right the first time. If a nurse just asks someone to authorise prescriptions, say a colleague who is authorised to subscribe prescriptions, without having actually seen the patient, then it is the colleague who is accountable for making the prescription. The patient could potentially be pregnant, in which case the nurse would be accountable for providing an inaccurate assessment of the patient. So prescribing on behalf of a colleague makes the prescriber accountable for anything that goes wrong and it is the prescriber against whom action is taken if there’s a legal case. Further, it is not just legally that a prescriber gets bound but also it’s unethical if the prescriber gives prescriptions without really knowing about the situation. Even though it would seem selfish on part of prescriber to not prescribe the medications just because this puts the prescriber accountable but it is better to evaluate the situation before making prescriptions. In spite of the duty that one holds towards a patient a prescriber should take care before signing a prescription unless it’s an emergency. It is absolutely imperative that, ideally, whoever is writing the prescription(s) physically sees the patient. Not only is this a way of keeping other medical personnel professionally responsible for their actions, but it is also the right ethical consideration to take into account—which will be discussed more at length in the triad section. In short, it is important that all factors be taken into consideration when prescribing medication. Next, the legal implications of prescribing medication will now be entertained, taking into account current
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