Question one
Under the Nursing Practice Act, Section 213.38, misconduct against falsification of information is addressed. In case of such incidences, Section 301.401-.402 dictates that the nurse, or any other member, who comes across such discrepancies should file a complaint, where the board, after determining the ground of discipline under Section 301.452, can open a formal investigation and write a letter to the accused detailing all the allegations raised against them and offering a maximum of 30 days to get a formal feedback from the accused.
Question two
As a nurse, she ought to be well conversant with the Nursing Practice Act that governs all their activities. Appending one's signature, on any narcotics sign-out, leaves one accountable for any discrepancies that may arise. Having this in mind, the nurse would have politely declined the request without formal documentation abdicating her from the offence. This is because the board comes first, and its main purpose is to protect the nursing profession, hence no one should think they can get away with such an offence. In the given scenario, the hospital is understaffed. Therefore, the most practical approach will be to obtain a written requisition from the doctor for the extra narcotics dosages, and on the first encounter with your supervising nurse, explain the activities that took place, even if the doctor refused to have the directive on record. This can go a long way in protecting them from losing their license hence preemptively keeping themselves in good standing with the employers.
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Question three
Since a witness needs to append a signature before signing out narcotics, the nurse should produce a safe harbor form that is signed off by all the relevant authorities in case there are no nurses present to serve as witnesses. The form will enable the nurse to proceed with the task at hand as well as serve as a safeguard against wastage and misappropriation of drugs. Moreover, it protects the nurse from the risk of losing their license. Failure to have the form filled, nurses, according to the American Nurses Association, have the freedom to reject, accept or object, in written form, any task that might put the nurse herself or the patient at risk. This way, all narcotic circulation will be controlled a great deal since misappropriation will be minimized.
References
Russell, K. A. (2012). Nurse practice acts guide and govern nursing practice. Journal of Nursing Regulation , 3 (3), 36-42.
Rules and Regulations relating to Nurse Education, Licensure and Practice. (2014). Retrieved from http://www.bne.state.tx.us/pdfs/law_rules_pdfs/rules_regulations_pdfs/bon_rr_Oct2014.pdf
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements . Nursesbooks. org.
