•Suggest additional ethical and legal implications for all stakeholders in your colleagues’ scenarios.
•Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
•Validate an idea with your own experience and additional research.
SCENARIO 3

Nurse practitioners are regulated by state boards of nursing or other state designated agencies in which they practices, therefore, it is their responsibilities to know the laws and regulations in their state of practice to avoid litigation (Arcangelo & Peterson, 2013).

In Maryland, a nurse practitioner is authorized to prescribe under the terms of a written agreement with a physician. The Maryland Board of Nursing supplies a form on its Website for this written agreement. The form asks for the practice’s address and a description of the practice and patient population (Maryland Board of Nursing, 2010). If a nurse practitioner prescribes for an individual who is not a patient of the practice described, then the prescribing is outside of the written agreement, and therefore is not authorized by law. In addition the Maryland State Board of Nursing Rules and Regulations, Annotated Code of Maryland (COMAR 10.27.07.10) outlines the following documentation requirements for prescribing: 1) there shall be a medical record on the patient/client to document the prescription of the medication. 2) The prescription must be within the prescriber’s scope of practice and 3) the prescription shall be documented on the medical record in accordance with COMAR 10.27.07.10. (Maryland Board of Nursing).

In the above scenario, since the husband is not the patient of the nurse practitioner, how is she going to have access to the patient medical record to do a proper documentation of the narcotic prescription? This will result in a breach of the Maryland nursing Acts of 2010, therefore the incident need to be reported. Moreover, the Federal law requires that controlled substances be prescribed only in the context of a bona-fide physician-patient relationship, including a written record.
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