WEEK 1 SCENARIO:
TF is an 18-month-old boy who was admitted to your hospital for failure to thrive and losing 6 lbs. You have found that he has extreme blockage throughout his GI system with severe impaction throughout. He is in a great deal of pain and is screaming. His parents are adamant that they do not want treatments due to religious beliefs. They have stated that they boy’s grandfather, an elder in their church, is on his way to pray over the boy and heal him.
Write a 2 page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
-Sample Answer-
Ethical and Legal Implications:
In the given scenario, the ethical implications involve the rights of the patient versus the autonomy of the parents. The patient, TF, is in a great deal of pain and is in need of medical treatment. However, the parents are refusing treatment due to their religious beliefs and have stated that they believe the boy can be healed through prayer. This presents a conflict between the patient’s right to receive necessary medical care and the parents’ right to make decisions for their child based on their religious beliefs.
From a legal standpoint, there may be issues related to medical neglect if the parents continue to refuse necessary medical treatment for their child. In some states, there are laws that allow for medical treatment to be given to a minor against the wishes of the parents if it is deemed to be in the best interests of the child. It is important to be aware of the specific laws in the state where the hospital is located and to consult with legal counsel if necessary.
Strategies to Address Disclosure and Nondisclosure:
In this scenario, it is important to consider both the ethical and legal implications of disclosure and nondisclosure. One strategy to address these issues could be to involve a third party, such as a mediator or ethicist, to help facilitate a discussion between the healthcare providers and the parents. This could help to identify any potential misunderstandings or areas of agreement and allow for a resolution to be reached that is in the best interests of the patient.
Another strategy could be to seek a court order to allow for necessary medical treatment to be administered to the patient. This may be necessary if the parents continue to refuse treatment and the patient’s condition is deemed to be life-threatening. In this case, it is important to be transparent about the reasons for seeking a court order and to provide the parents with the opportunity to voice their concerns and objections.
As an advanced practice nurse, two strategies that I would use to guide my decision making in this scenario would be:
Prioritizing the patient’s well-being and advocating for their right to receive necessary medical care: As a healthcare provider, my primary duty is to the patient and their well-being. In this case, it is important to advocate for the patient’s right to receive necessary medical treatment, even if it is against the wishes of the parents.
Engaging in open and honest communication with all stakeholders: In order to address the issues of disclosure and nondisclosure, it is important to engage in open and honest communication with all stakeholders, including the healthcare team, the patient, and the patient’s family. This can help to build trust and foster a collaborative approach to decision making.
Process of Writing Prescriptions:
The process of writing prescriptions involves several steps to minimize medication errors. Some strategies that can be used to minimize errors include:
Verifying the patient’s identity: It is important to verify the patient’s identity before prescribing medication to ensure that the correct medication is being prescribed to the correct patient. This can be done by checking the patient’s identification, such as their name and date of birth, and comparing it to the information on the prescription.
Checking for allergies and drug interactions: It is important to check for allergies and potential drug interactions before prescribing medication. This can be done by reviewing the patient’s medical history and any known allergies, as well as checking for potential interactions with other medications the patient is taking.
Clearly documenting the prescription: The prescription should be clearly documented, including the name of the medication, the dosage, the frequency of administration, and any special instructions. This can help to minimize misunderstandings and reduce the risk of errors.
Ensuring accuracy and legibility: It is important to ensure that the prescription is accurate and legible to prevent errors. This can be done by double-checking the information and handwriting, as well as using electronic prescribing systems where possible.
As such, the scenario presented involves complex ethical and legal implications that require careful consideration and collaboration among all stakeholders involved. Strategies such as involving a third party, seeking a court order, and prioritizing patient well-being can help to address disclosure and nondisclosure issues. Additionally, the process of writing prescriptions involves several steps that can be taken to minimize medication errors, including verifying patient identity, checking for allergies and drug interactions, clearly documenting the prescription, and ensuring accuracy and legibility.
References
American Nurses Association. (2021). Code of ethics for nurses with interpretive statements. Retrieved from https://www.nursingworld.org/coe-view-only
Centers for Medicare & Medicaid Services. (2022). State operations manual: Appendix A – interpretive guidelines for hospitals. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_a_hospitals.pdf
National Council of State Boards of Nursing. (2021). Nurse practice act and rules. Retrieved from https://www.ncsbn.org/npa-and-rules.htm
American Medical Association. (2022). Principles of medical ethics. Retrieved from https://www.ama-assn.org/delivering-care/ethics/principles-medical-ethics
