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Legal and Ethical Standards for Advanced Practice Nurse With Prescriptive Authority

As an advanced practice nurse, I am guided by ethics and policies to avoid errors in my practice; however, these ethics and policies vary from one state to another. One of the most common errors in my practice occurs during the administration of drugs which may be in the form of dispensing wrong drugs and formulations or, in this instance, issuing the wrong prescription, i.e., giving a five-year-old a dosage suitable for an adult. In such a scenario, the patient, who is a five-year-old, tends to be the most affected by this action, especially when it comes to their health, and at times their trust for the nurse goes down. Subsequently, all stakeholders involved, the advanced practice nurse (prescriber) and the pharmacist, are affected by this chain of incorrect drug prescriptions.

Legal and Ethical Implications

In the event of a wrong prescription, all stakeholders involved in this process are affected. These stakeholders include the patient and their family, the advanced practice nurse who is the prescriber, and the pharmacist who issued the drugs (Rodríguez & Juričić, 2018). Following the legal and ethical standards for advanced practice nurses with prescriptive authority, the nurse is at the top of the contagion effect of administering the wrong prescription to a five-year-old patient as the error starts with them. Being an advanced practice nurse, one must diagnose and treat an ailment correctly and fully know their patient details such as age, allergies, mental health, and conditions, among others (Zarea et al., 2018). In this case, the nurse is fully aware of the patient’s age, i.e., five years old but still makes an error of prescribing drugs that are fit for an older person, which may impact the patient negatively by leading to an overdose and, in some cases death. Thus the advanced practice nurse is guilty of making an unjustified legal and ethical error.

The pharmacist who is responsible for dispensing the drugs, monitoring drug safety, and regulating drug dosage comes second in this chain of events in administering the wrong medical prescription. With the roles bestowed upon him by the state’s pharmacy board, the pharmacist should have illustrated more interest in the patient receiving the drugs they dispensed and monitored and regulated drug safety (Delpasand et al., 2019). This could be done by asking follow-up questions about the patient, such as their age and health conditions, before making the prescription. These questions are essential in helping them decide the kind of prescription to make; however, the pharmacist failed to ask, thus issuing an older person’s prescription to a five-year-old, making them guilty according to legal and ethical standards in this practice. The patient who is most affected in this scenario can take legal action against the nurse, the pharmacist, and the hospital who issued the wrong prescription hence legally and ethically liable.

Disclosure and Nondisclosure Strategies

In March 2019, my state, New Jersey, signed a new law through its governor Phil Murphy that forbids nondisclosure provisions in workplace compensation deals. These disclosure and nondisclosure strategies ensure increased capabilities for surveillance of workplaces to identify employee errors and mistakes and their intensities to determine the course of legal action taken (Ngiam & Khor, 2019). Administrators in the medical field are trained to identify medical errors such as administration of a wrong prescription and how frequent they occur to take legal action against the employees involved and develop strategies of curbing this error (Zarea et al., 2018). These strategies are also crucial in identifying fake and incompetent practitioners. Failure to report an error like administration of wrong prescriptions may affect the patient’s wellbeing, thus dire consequences for the nurse and pharmacists involved. Hospitals need to develop effective ways of identifying, reporting, and rectifying errors to improve their competency, which is an overall reflection of the hospital.

Decision Making Strategies

A nurse needs to report an error after it has occurred as required by the legal and ethical nursing standards. The principles one would use in such a scenario are the principles of integrity and beneficence. The principle of integrity requires one to be truthful in their practice, and in this case, it would be reporting the error of administering the wrong prescription to a patient (deSante-Bertkau et al., 2022). Following the code of conduct and the guiding ethical principles in nursing, one must file a medical report that recounts what led to this particular mistake and how it occurred. Additionally, one can use the nursing principle of beneficence to decide in the event of a medical error. This principle ensures that any medical practitioner does the right thing by a patient and no harm comes to them (Delpasand et al., 2019). After reporting the error, the advanced practice nurse should keep checking on the patient and taking note of any slight changes in their behavior to ensure that the combination is adequately managed. These two principles will guide one in making the right call despite the consequences and ensure the patient’s safety.

Writing Prescriptions

After analyzing a patient’s conditions, one must write a prescription. This prescription specifies what the patient needs to fight the illness at hand; thus, an appropriate drug and dosage are selected. It also gives one crucial information like warnings and side effects of the drug (Zarea et al., 2018). After issuing a prescription, one is required to follow up to ensure that the drug is effective regularly. Advanced nurses should seek help in case of uncertainty to avoid errors.

In conclusion, it is common for one to make errors in the medical field, such as issuing wrong prescriptions. This error tends to affect the nurse, pharmacist, and the patient; thus, it should be reported. Medical practitioners who make errors should use ethical principles in this field to make the right calls. Additionally, states should develop disclosure and nondisclosure strategies that will help them minimize errors in workplaces. Medical practitioners are also encouraged to seek help in case of uncertainties to limit mistakes.


Delpasand, K., Afshar, L., & Tavakkoli, S. N. (2019). The Ethical Principles in Pharmacist-Patient Relationship. Journal of Clinical & Diagnostic Research13(3).

deSante-Bertkau, J. E., Knilans, T. K., Persad, G., Zettler, P. J., Lynch, H. F., & Antommaria, A. H. M. (2022). Off-label prescription of COVID-19 vaccines in children: clinical, ethical, and legal issues. Pediatrics149(2).

Ngiam, K. Y., & Khor, W. (2019). Big data and machine learning algorithms for healthcare delivery. The Lancet Oncology20(5).

Rodríguez, J. V., & Juričić, Ž. (2018). Perceptions and attitudes of community pharmacists toward professional ethics and ethical dilemmas in the workplace. Research in Social and Administrative Pharmacy14(5).

Zarea, K., Mohammadi, A., Beiranvand, S., Hassani, F., & Baraz, S. (2018). Iranian nurses’ medication errors: A survey of the types, the causes, and the related factors. International journal of Africa nursing sciences8.


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