Thecase study involves an ethical dilemma where the medical assistanceand a licensed practical nurse, Jerry is expected to determinewhether to refill a prescription without permission from the doctor.The medical assistance is expected to receive phone calls wheneverthe facility’s receptionist is taking a lunch break. It is duringthis time when a patient calls requesting for a prescription refillthat is needed urgently (Fremgen, 2009). This paper will discussJerry’s qualification to refill the prescription, implications ofthe doctrine of respondeat superior, ethical and legal issuesinfluencing the Jerry’s decision and the best decision makingmethods.
Qualificationof Jerry’s medical training to issue prescription refill order
AlthoughJerry is a trained medical assistant and a licensed practical nurse,these qualifications do not allow him to refill a prescription orderfor the patient. In addition, Jerry is currently assigned the role oftaking the prescription order and transcribing them for the doctor,who then acts on the orders by prescribing or refilling theprescription requests. Minnesota Board of Nursing (2014) identifiedthe major things that a licensed practical nurse is not allowed todo. For example, LPN is not allowed to write a drug, direction, ordosage on the prescription form that is pre-signed by the authorizedprescriber. The three restrictions indicate that Jerry is under nocircumstance permitted to refill the prescription order, even if thepatient needs the medication urgently.
Thedifference made by the fact that the medication was meant for thehigh blood pressure that the client has been using on a daily basis
Thechange of situations where the medication is critically required forblood pressure treatment would not change Jerry’s qualification asa medical assistant and a licensed practical nurse. This means thatthere are no circumstances that would excuse Jerry to exceed hismandates and refill the prescription order, even if the patient is atrisk or is in a critical condition. The roles of licensed practicalnurses are restricted to the administration of medication under theinstructions of a qualified physician (Bair, 2015). They are onlyallowed to refill mediation orders after informing the physician andreceive the permission to do so. In this case, Dr. William is absentand there is no qualified physician to give a prescription ofrefilling instructions to Jerry, which implies that the patient’sconditions cannot make any difference. Laws that define the roles andresponsibilities of different health care professionals are meant toprotect both the patients and the health care providers, and theycannot be altered to suit personal circumstances.
Jerry’sprotection under the doctrine of respondeat superior in case thepatient develops adverse reaction
Incase Jerry refills the prescription order and the patients respondsadversely, he can be held liable for malpractice under the doctrineof respondeat superior. This doctrine holds that the principle (oremployer) should be held liable for the actions of the agent(employee) that are within the scope or the course of employment(Coderch, Liguerre & Garcia, 2002). The doctrine allows thecourts to determine whether the agents or the employee acted withinthe scope of their employment. The court can review the jobdescription, purpose of the agent’s acts, and assigned duties. Thisimplies that an employee who takes actions outside the scope ofemployment can still be held liable for those actions. Impliedly, therefilling prescription order is outside Jerry’s qualifications,which means that he can be held liable for the medication thatculminates in adverse reactions.
Jerryshould reject the patient’s request, but give reasons and thepossible solutions. For example, Jerry should inform the patient thatthe doctor is absent and he has no authority to refill theprescription order without the doctor’s permission. Since thepatient is about to take a flight, it would not be advisable to tellhim to wait for the doctor to return. Therefore, Jerry should directthe patient to a qualified physician where the client can get propermedication in time.
Ethicaland legal issues affecting Jerry’s decision
Thelegal issues that might influence the Jerry’s decision include theobligation to observe laws that define the roles as well as theresponsibilities of LPN. For example, many states do not authorizeLPN to prescribe drugs, which means that offering medicalprescription services can lead to litigation against Jerry. Inaddition, nurses are guided by the code of ethics that describes thescope of their work and how to perform their duties without harmingtheir clients or themselves. For example, the ethical element ofresponsibility requires that nurses should evaluate all possibleconsequences of their decisions on client’s well-being and health(Robertson & Walter, 2007). In addition, Jerry should feelempathy for the patient. However, this does not mean that Jerryshould fulfill the patient’s request the prescription refilling,but should offer a suitable solution, such as directing the patientto a qualified physician.
Jerryshould use the consequentialism approaches in making the decision onwhether to refill the prescription order or not. For example, usingthe utilitarian theory, Jerry can determine which alternative willminimize suffering for the patient and himself (Robertson &Walter, 2007). For example, Jerry can consider the possibility ofgiving drugs to the patient for the wrong type of illness and whatmight happen to his career and the health of the patient as aconsequence of the decision. Therefore, the most appropriate methodof decision making in this case is the one that helps Jerry weigh theconsequences.
Jerryshould be guided by the code of ethics and the principles ofconsequentialism in making the decision on whether to refill theprescription order or not. Laws and principles that govern the healthcare practices should not be overlooked to favor patients in certainsituation. Therefore, Jerry should only deliver services that arewithin his abilities and professional qualifications.
Bair,D. (2015). Eightroles of the LPN.Van Nuys, NA: Practical Nursing Organization.
Coderch,P., Liguerre, C., & Garcia, J. (2002). Vicariousliability and liability for the action of others.New York, NY: Stockton Press.
Fremgen,F. (2009). Medicallaw and ethics.Upper Saddle River: Prentice Hall.
MinnesotaBoard of Nursing (2014). Nursesand prescribing frequently asked question.Minneapolis, MN: Minnesota Board of Nursing.
Robertson,M. & Walter, G. (2007). A critical reflection on utilitarianismas the basis for psychiatric ethics. Journalof Ethics in Mental Health,2 (1), 1-4.