Ethical-Legal Dilemma, Prescribing Pain Medication
4 days after having a devastating traffic accident which totaled his car, Dr. John Brown, a 36-year-old physician that you have been working with at a primary care clinic for the past 6 months since graduating from UC FNP program, starts complaining of severe left shoulder and neck pain. Immediately following his accident, Dr. Brown had been taken to the local Emergency Room. He was hospitalized overnight and numerous x-rays and scans were done. Dr. Brown suffered a severe left AC separation and cervical strain. Unfortunately there was no orthopedic coverage the night he was there so he was placed in a sling and swathe and given an orthopedic follow-up. Upon discharge the hospitalist prescribed him Tramadol 50 mg PO every 6 hours as needed for pain. Dr. Brown insisted on returning to work until having shoulder surgery. You overhear Dr. Brown talking on his phone with the hospitalist who treated him and complaining that the Tramadol is not helping the pain. Dr. Brown becomes agitated and is yelling at the other physician, demanding Percocet 10/325 mg tablets. After failing to convince the hospitalist, he slams his phone down. He is scheduled to see the orthopedic surgeon in 3 days as soon as he is back in town. Being unable to self-prescribe, Dr. Brown turns to you and begs you to write him enough Percocets to take every 6 hours for the next 2 weeks. You feel sorry for Dr. Brown because you can see he is in pain but you have never treated him before as a patient and you are unsure about calling this medication in for him.
Write 2-3 paragraph response statement to the following questions:
1. What are the legal dilemmas in this case study? Please refer to the KBN website for assistance.
2. What are the ethical violations occurring in this scenario?
3. How should the APRN handle this situation? How could this adversely effect the physician-NP relationship in the future?
Include one ethical principle and one KY law that could be potentially violated and whether the violation would constitute a civil or criminal act based on facts. Support the legal issues with prior legal cases or state or federal statutes. Support your dilemma with statistics, KBN regulations on prescribing and or evidence-based research form a peer reviewed journal article. List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma. This is a fact-based assignment and should not include your opinion. Please make sure to cite all references appropriately.