The Use of Morphine in Health Care - Assignment Example

The use of Morphine in health care Name University Affiliation Question1 From a legal perspective of prescribing, checking and administering morphine, detail the tasks that were performed incorrectly. All drugs have their own way of legally prescribing by the health care professionals. The professionals are it the doctors or the nurses are required to follow strictly the rules and regulations stipulated in prescribing the drugs to the patients. This is to ensure safety of the patients to avoid accidents of overdose or under-dose situations that can lead to health complications or even death. Morphine is among the drugs that require strict adherence to the instructions when prescribing them to a patient because of its addictive nature and adverse side effects. The legal perspective of prescribing morphine is that morphine oral solution is available in 10mg, 20mg, 100mg all these quantities are per 5ml concentration (Adhb.govt.nz ).The 100 mg/5ml concentration is meant foe use to opioid tolerant patients. The prescription rule demands that care must be take by a health officer when prescribing it to avoid dosing errors that come because of the confusion between the different concentration between milligrams (mg) and milliliters (ml). This confusion could easily lead to overdose and death. The nurses or doctors should be cautious in that to ensure proper communication and dispensation.The drugs law requires that the administration of morphine should be done by registered nurses who have completed their competency for intravenous administration of morphine. The nurse should be assessed to be competent for medication administration (Adhb.govt.nz ). The nurse or doctor should adjust the dose administration to the patient individually bearing in mind the patient’s prior analgesics treatment. In administering the initial dose, the administrator should observe the following; the patient’s degree of opioid tolerance, the general condition of the patients, and the severity of the patient’s pain concurrent medications (Psychiatry.org, 2009). These rules have been put in place because morphine is a dangerous drug which cannot be administered to patients having certain health complications. This is because morphine is known for increasing blood pressure, has gastrointestinal effect, it is also known for impairing the mental and physical abilities hence should not be used to patients who operate the machines or drive vehicles. From the case study, both the nurses and the doctor committed an offence. First, the doctor should not have allowed the nurse to administer morphine to the patient without his presence. The nurse seems to have less knowledge on how to mix the drugs; he mixes 5mg/0.5ml instead of 5mg/5ml. The law drugs states that the administration of morphine to patient should be 5mg/5ml, 10mg/5ml or 100mg/5ml. Thus the nurse confused the ratios ending up giving the patient the wrong content of the drug. The doctor should have checked the patient’s conditions as required by law before allowing the nurse GK to administer morphine. Therefore, the doctor breached the legal duty of care to the patience by neglecting his duty. Mr. Mj the patient can successfully sue the doctor in court for the tort of negligence because the doctor had a legal duty of care to him but neglected his duty. Another act that was done wrongly according to drugs act specifically the Morphine drug is that Nurse AB could not allow nurse GK to check the drugs on her own from the cupboard even if she was busy. As mentioned earlier, Morphine is a dangerous drug that should not be allowed to be accessed by any one. She would have checked and signed in by herself because the law requires that checking and signing of the release of drugs in the group of Morphine should be done by one individual for accountability purposes. Therefore, she can also be sued for the tort of negligence in the court of law. Another act that was done wrongly is that morphine should not be kept at an open place because it is a dangerous drug when misused. Nurse GK keeps the remaining drug at the bedside of Mr. Mj to be given to him later own. This is a dangerous act because the patient may attempt to take this drug on his own incase he would feel much pain; this may lead to drug abuse. The law provides dangerous drugs such as morphine should be kept in a locked cupboard. Thus, Nurse K care also breached the rules governing drugs by being careless. Question2 Explain how you would perform these tasks if you were put in Nurse GK’s situation. Provide the rationale for your answer. Incase I was in a situation like this of nurse GK, I could not accept to check the drugs on myself from the cupboard as requested by nurse AB. This is because nurse AB is the one responsible with the duty of checking and signing of the release of morphine drugs from the store. The law requires that one who is responsible for checking and withdrawing of the drugs from the store should be one person for accountability purposes incase a problem occurs. Therefore, I would wait nurse AB to complete her duty and come and countersign the ease the drug on her own. Secondly, incase could face such a situation like nurse GK, I would have asked the doctor to come on his own to examine the patient’s condition first before administering morphine. I could not have accepted the doctor’s instruction that I give the patient morphine without his presence since the drug is quite dangerous. The law that govern the administration of morphine to patient requires that the health care taker should examine thoroughly the health condition of the patient that ought to be given morphine since morphine has very many and dangerous side effects (Adhb.govt.nz ). This should not just left to the inexperienced nurses, but it should involve the doctor himself to check on the things such as blood pressure, the amount of the pain and the general health condition of the patient. Another thing that I would not have done in this situation is that I would not have given the morphine drug to the patient without checking the correct ratios as required in the administration of the drug. Nurse GK rushed to given the injection of morphine to a patient without being sure with the correct ratios of mg and ml. This is a serious offence she committed and could lead to the serious side effects or even death. It was an offense that could amount to a court case. Lastly, I would not have accepted giving the patient morphine drug because I had not completed the competency for intravenous administration of morphine. Thus, nurse GK should not have administered the drugs to the patient since the law requires that the administration of morphine should be done by registered nurses who have completed their competency for intravenous administration of morphine. Therefore, nurse GK breached the rules of drug administration. Question 3 To which drug group does morphine belong? Why should it be stored in a locked cupboard? Morphine belongs to drug group called the opiates, these are drugs that have the of opium ingredients in them. Morphine is a natural product extracted from the opium plant; this drug is among the strongest mind-altering drugs (Accessdata.fda.gov ). The major use of morphine drug in medical field is relieving pain. It is one of the best pain control drugs in patients who are undergoing severe and persistence pain for example that that results from surgery, delivery, accidents etc. In spite of the fact that it is a good pain killer, the doctors give it the last option among other pain killers when prescribing for patients (Psychiatry.org, 2009). This drug is long known to act on receptors expressed on the cells of the central nervous system leading to pain control and relief. Morphine drug is required by law to be kept under locked cupboard. Worldwide, morphine is considered to be a dangerous drug hence there are restriction on the use and handling of the drug. It is considered to be an illegal drug because it is under narcotics; this means that it additive and when the users become addicted to it, it affects them negatively (Uq.edu.au. 2010). It is one of the mind altering drugs, therefore, the governments restricts the use of this drug just for only medical purposes. When any person is found with this drug without the authority he/she can be sued in court for possessing illegal item that harm the society. This is why it is supposed to be kept under locked cupboard not to be accessed by any body because t can be misused. Another reason why morphine has to be kept under locked cupboard is that it causes allergies when exposed in open place (Wiley, 2011). Morphine and other opiates is common antigen in allergic reaction. Therefore, it can easily cause allergic health complications when not kept well. Moreover, morphine is a respiratory depressant; it is a central nervous system and respiratory depressant Wiley, Katherine. (2011). Thus extreme caution is required when administering to the patient. All these effects are the ones that make morphine to keep carefully retrieved only when one wants to give the patient. The law requires that the restricted drugs should be kept a locked cupboard, drawer, fridge, freezer and any other place where there is minimal reach of the public. Question 4 To which Schedule does morphine belong? What regulations and characteristics are associated with this schedule? State the names of 3 other drugs that belong to this Schedule Every continent around the world has its own way of classifying drug schedule. Therefore, morphine drug is classified under different schedule depending with the country. In the United States, Morphine is under schedule 2, in Netherland it is under schedule 1, while in Australia it is under schedule 2 (Uq.edu.au, 2010). This drug is under the restricted drug, it is a restricted drug because it has very adverse effects when misused by the users that is why the governments comes in to restricts its movements and use. Some other drugs under this schedule are; Heroin, oxycodone, hydromophone, codeine, cocaine, methodone etc. These kind of drugs are considered to have some medical value hence they health professional are allowed by law to use this drugs to treat certain kinds of health problems Wiley, Katherine. (2011). In spite of having some medical benefits, drugs from this schedule are very dangerous and have many sides’ effects when exposed to the public that is why they are kept under lock. The drugs are not allowed to be used by any other person with prescription from the authority. It is would be a big offense if one is found with these drugs. For example in American when one is found with this illegal drug, he can be sued and jailed for seven years. The main characteristic of the drugs that belong in schedule 2 or restricted drugs as mentioned earlier is that they have some medical importance but are restricted due to their addictive nature (Uq.edu.au. 2010). Some of other characteristics of this schedule are that the drugs have high potential abuse which may result to severe psychological or physical dependence. Schedule 2 drugs are also stimulants in that they cause irritability, increased blood pressure, impaired judgment and cardiovascular problems. They are mostly narcotics. Narcotics drugs lead to severe physical and psychological dependence. Question 5 From an ethical perspective, state which principles have not been followed in this situation. Explain your answer. In current times, every profession has developed ethical principles which guide its members when discharging the duties. The medical profession like any other profession has formed a body of ethical statements developed primarily just for the benefit of the patient. (Limentani, 1999). As a member of the profession, a doctor or a nurse must be in a position to recognize his/her responsibility to patients as well to the society at large. The code of ethics is a vital element in the medical profession control of the behavior of physicians and nurses where they are required to ct with integrity in the extreme circumstances (Psychiatry.org, 2009). When the codes and principles are observed in medical field, they help in thinking in difficult and moral issues when seeking to defend subsequent decisions. From the case study, a number of ethical principles were not adhered to by the nurses and the doctor. For example, in the medical ethical conducts, there is a principle that states that a physician shall, while caring for a patient regard responsibility to the patient as paramount. We have found that this principle was not observed by the nurses and the doctor. The doctor just instructed nurse GK that she goes on administering morphine drug to Mr. MJ without keeping in mind that he should check the health condition of the patient before allowing this. Thus, he breached the principle of giving paramount care to the patient. Another principle that is found in medical ethical conducts states that, a physician shall respect the rights of the patients, colleagues and other health professionals and they are required to safeguard the rights of the patients and privacy (Limentani, 1999). From the case study, this principle was breached by Nurse AB who just directed nurse GK to go and perform the duties on her behalf. Checking and countersigning the retrieval of morphine drug a dangerous drug was not to be done by nurse GK. Here, nurse AB did not show respect as required by law when she told her fellow to go herself to the cupboard to take morphine and countersign. Lastly, another principle in medical ethics states that a physician should uphold the professional standards, be honest and show competence in their work. Nurse GK did not observe this principle because she just mixed wrong ratios of the drug when she was injecting the patients (Limentani, 1999). This shows that she did not have any good knowledge in morphine administration, thus she was not a competent professional. References Adhb.govt.nz. Morphine administration. Retrieved from http://www.adhb.govt.nz/starshipclinicalguidelines/_Documents/Morphine%20Administr ation.pdf Accessdata.fda.gov. Highlights of prescribing information. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022195s006lbl.pdf Legislation.qld.gov.au. (2012). Health (Drugs and Poisons) regulation 1996. Retrieved from http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/H/HealDrAPOR96.pdf Limentani, Alexander. (1999). The role of ethical principles in health care and the implications for ethical codes. Retrieved from http://jme.bmj.com/content/25/5/394.full.pdf Uq.edu.au. (2010). Schedule drugs and poisons. Retrieved from http://www.uq.edu.au/ohs/pdfs/OHYG-schpoisonsdrugs.pdf Psychiatry.org. (2009). American Psychiatric Association. The principles of medical ethics. Retrieved from http://psychiatry.org/File%20Library/Practice/Ethics%20Documents/Ethics-Principles- 2009.pdf Health.govt.nz.(2011). Medicines care guides for residential aged care. Retrieved from http://www.health.govt.nz/system/files/documents/publications/medicines-care-guides- for-residential-aged-care-may11.pdf Wiley, Katherine. (2011). Pocket drugs classification. F a Davis Company. Read More