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The nursing profession is underpinned by many professional, legal and ethical issues that are vital for safe practice and ensure the best interest of patients are being met. On the contrary, Ethics are the standards of moral judgement and professional conduct whereby these interests are met (Dewit & Oneill, 2013). Nurses are subjected to a large number of ethical, legal and professional duties as they highly responsible to patients and the public as the entire profession. As such, nurses are governed by legal and professional requirements that protect the safety and wellbeing of patients but also have ethical considerations that arise when delivering nursing care (Dewit & Oneill, 2013). Therefore, this professional obligation is legalized all over the world which when breached can lead to legal implications or lawsuits. In doing so, a nurse must be registered and have a license in order to be recognize as a professional in the line of duty. This essay will elaborate more on the laws and ethics in which nurses may abide by them and the responsibilities they take in administrating dangerous drug accordingly with the Dangerous Drug Policy.
Nurses may come across diverse dilemmas, legal or ethical in nature amid their practice; nevertheless, some of the nurses may not be prepared to respond to such issue and may end up helpless in the event that questions regarding their ethics or conduct are raised. Frequently, the interaction between ethics and law is complex; however, professional nursing ethics mainly followed within the confines of the law are highly likely to be legally defensible. In doing so, a law has been made for nurses to abide by it for the safety of the patients and the profession itself (Dewit & Oneill, 2013).
Therefore, the law informs nursing at every stage and it is essential that you understand and are able to critically reflect on the legal issues relevant to nursing practice. As a registered nurse you will be legally and professionally accountable for your actions, irrespective of whether you are following the instruction of another or using your own initiative.
Although it represents a rule concisely laid down whereby any deviation from the set rule attracts punishment; however, ethics are not measurable and cannot be concisely defined like law. Ethics mainly depend on personal perception of issues and are complex to be outlined into right or wrong (Dewit & Oneill, 2013).
Therefore, it is important for the laws to exist in the nursing profession as it provides a framework for which Nursing actions in the care of clients are legal, protect clients rights, it helps to make boundaries of independent Nursing action, it assists in maintaining a standard of Nursing practice by making Nurses accountable under the law.
Prior to the legal obligations of nurses, nursing was to be regulated and restricted by requirements of training and education to be a registered and qualified nurse. Without licensure, anyone could practice as a nurse, irrespective of whether they had received training. This not only put the lives of patients at risk but also exposed practicing nurses to the risk of exploitation, such as through low pay and poor working conditions (Dewit & Oneill, 2013). The purpose of the license is to protect the public from any harm as the nurse must be qualified to take care of the patient. This proves that the persons qualifications are approved by the Council and authorized to be register as a nurse.
This registration provides assurance to the public that the nurse has met predetermined standards and is recognized by the public that the person is a qualified nurse with knowledge of proper and safe practice in the profession (Dewit & Oneill, 2013). Licensure benefits both the general population and the individual medical caretaker since fundamental capabilities for nursing practice are distinguished; an assurance is made with respect to whether an individual meets those capabilities; and a target gathering is given to survey of concerns in regards to an attendant’s training when required (Dewit & Oneill, 2013). Licensure benefits medical caretakers since approval from the legal authorized personnel or the Council established the safe practice of the profession for the general population and nurses (Dewit & Oneill, 2013).
In other words, this grants permission to practice as a nurse after verifying the applicant has met minimal competencies to safely perform nursing activities within nursing’s scope of practice. Licensure is necessary when the regulated activities are complex, require specialized knowledge and skill and independent decision making. These provides nursing activities may only be legally performed by individuals holding a nursing license issued by the regulatory body, a title protection whereby only the persons issued a license are legally permitted to use certain titles, such as registered nurse, advanced practice registered nurse, etc. In addition, in order to assure that the public is protected, authority is granted to the regulatory body to take disciplinary action in the event the licensee violate the law or any rules promulgated by the regulatory body.
In addition, when a nurse violates the ethical standards of the profession by failing to meet the nursing standards and breaching the standard practice they are liable to cause professional misconduct leading to a disciplinary action of the Nursing Council by de-registration and removal of their license (Marquis & Huston, 2017)These professional misconduct can be either physical or verbally abusing the rights of a person either directly or indirect approach, or unable to conduct their work carefully and accurately.
Such misconduct includes inaccurate documentation when supplies are removed supplies from the workplace without authorization, and failed to conform to essential standards of acceptable nursing practice as defined in the state nurse practice act (Joel, 2018). This can lead to the nurse being reprimanded. Secondly, failing to maintain professional boundaries with a patient and used intoxicants to the extent or in a manner injurious to herself or others can lead to the license being revoke. Falsified prescription and violating patients right of privacy are against our obligations and ethical standards (Joel, 2018). This include when pictures and videos of the patient are taken without the permission of the client and the sharing of information with others.
Thirdly, the relationship between two parties either between nurse and a co-worker or with the patient or patients relatives becoming unprofessional especially when there is a sexual relationship between the two (Joel, 2018).
Moving on, the policy of dangerous drugs or Dangerous Drug Act regulates to prevent the misuse of narcotic drugs and psychotropic substances in a healthcare setting. This act on the controlled drug being supplied and used in accordance with the Dangerous Drug Ordinance and the Drug Regulation. With this policy, the sale and distribution of dangerous drugs are exception only to authorized personnel or licensed pharmacy. This primary basis of it is for the controlled drug must be accounted for and an audit on its trail to be maintained. This entails the disciplinary actions for criminal action on drug abuse when professional misconduct is to be made. In addition, such dangerous drugs are prohibited in manufacture except licensed premises that meet the conditions specified by law (Law of Fiji, 2014). This policy also applies to medical practitioners on prescribing and dispensing dangerous drugs (Law of Fiji, 2014).
Furthermore, when ordering dangerous drugs or medication to replenish the supply, several factors must be taken into consideration. Firstly, each healthcare settings must have a Controlled Drug storage room or cupboard for storage and stocktaking. Each unit must establish a minimum stock level to store preceding orders and to indicate the maximum level of the storage (Law of Fiji, 2014). The Controlled drugs are to be ordered within a specific unit only to be administered to specific patients of that unit accordingly. Before the order is made, an Order Book must be signed by a sister in charge. This form is on the Controlled Drug Order Book whereby it should be arranged in order by numbers, name of the drug, strength, dosage form and quantity of the drugs to be supplied as indicated by the Order Book (Law of Fiji, 2014).
A copy of this record or action must be documented in the Dangerous Drug register. Records and documentation of drugs must be kept properly by a doctor, pharmacist, or in this case, a registered nurse. The Chief Pharmacist or an Inspector has the power to inspect records at any time, hence, proper identification and documentation must be made and sighted before allowing access. The sister in charge must conduct monthly drugs stocktaking and checked by the Pharmacy, this way if any discrepancies like missing Dangerous Drugs or missing Register, the Senior Matron or Pharmacist in Charge will be notified immediately (Law of Fiji, 2014).
Alternatively, the storage of Dangerous Drugs as mentioned before, it must be kept properly in a double-locked cupboard labeled Dangerous Drug Cupboard separated from other medicines. No other belongings including documents to be kept in the storage, hence, a well-organized unit comes in handy as less confusion will be made preventing any professional misconduct. Only authorize personnel are responsible in handling Dangerous Drugs (Law of Fiji, 2014).
Upon administration, the registered nurse must ensure the safe administration of the Dangerous Drugs. It must be administered immediately after the preparation of the drug in the syringe whilst the unused portion of the drug be discarded (Law of Fiji, 2014). Dangerous Drug are restricted for outpatients in terms of oral formulations which can be obtained from Divisional and Sub Divisional MOH facilities only. Higher dosage of the drug beyond four week requires the approval of the Permanent Secretary for Health. Likewise, the continuing usage of the drug beyond four weeks without the permission of the Secretary is out of question. The administration of the drug must be given exactly on the drug schedule and to specific patients accordingly to their drug chart (Law of Fiji, 2014).
Moreover, not everything lasts including Dangerous Drug. When Dangerous Drugs become expired, they must be returned to the Hospital Pharmacy or to the Government Pharmacy to be destroyed, since only they can destroy the drugs. This is to prevent any Dangerous Drug being used for personal use. As for stolen drugs or lost drugs, it should be reported to the Senior Pharmacist of the unit as they are responsible when such Drugs are lost or stolen. When the registered nurses or sister in charge notice any missing drug without proper documentation, it should be reported to relevant authorities accordingly.
To conclude, Nurses are in a privileged position as they are trusted with the health of others. This comes with tremendous responsibility and nurse need to ensure that they are competent to deal with the professional, ethical and legal issues that arise in nursing. Nurses are accountable for their own practice and should make the interest of their patients their first concern. If nurses do not act in a professional manner and do what is ethically right, there can be serious repercussions to both the nurse and individuals in their care. Significantly, they must be registered nurses to be in this profession. They are also responsible for taking care of Dangerous Drugs and any misconduct is noticed, a lawsuit will be filed against the accused.
References
- Dewit, S. C., & Oneill, P. A. (2013). Fundamental concepts and skills for nursing. (4th ed.). Philadelphia, Pa. ; London: Elsevier Health Sciences.
- Joel, L. A. (2018). Advanced practice nursing : essentials for role development (4th ed.). Philadelphia, Pa: F.A. Davis Company.
- LAWS OF FIJI CHAPTER 114 DANGEROUS DRUGS ARRANGEMENT OF SECTIONS. (2014). Retrieved from http://www.health.gov.fj/wp-content/uploads/2014/09/8_Dangerous-Drugs-Act-Cap-1141.pdf
- Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing : theory andapplication (8th ed.). Philadelphia: Wolters Kluwer Health.
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