Nurse Safety and Prescribing Medications: A Delicate Balance

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Nurse practitioners work to maintain safety for nurses and patients when prescribing opioids

Approximately 130 Americans die each day from opioid overdoses, according to the U.S. Department of Health and Human Services (HHS). Nurse practitioners can help to address the challenges of the opioid epidemic by creating a culture that promotes patient and nurse safety when prescribing medications. Programs such as an BSN to DNP online can help equip nurses with the leadership skills they need to fulfill this role.

The Opioid Epidemic

The origins of the current opioid epidemic in the U.S. date back to the 1990s, when the highly addictive qualities of prescription opioids were not fully understood. The number of opioid-related deaths in 2016 reached 42,000. Prescription opioids accounted for about 40% of those deaths. The following year, HHS declared the opioid epidemic a public health emergency. Today an estimated 2.1 million people across the U.S. have an opioid use disorder.

How does the epidemic relate to the health care industry, specifically within the context of the delivery of patient care and patient safety? Prescription opioids can help to alleviate pain for patients after surgery and injury, and they can be used to treat certain health conditions. With the ability to prescribe medications with differing levels of physician oversight, depending on which state they practice in, nurse practitioners have to balance the benefits of prescribing opioids for pain management with potential risks, such as drug addiction and overdose. The Centers for Disease Control and Prevention (CDC) guidelines for health care providers encourage patient-centered clinical practices such as “conducting thorough assessments, considering all possible treatments, closely monitoring risks, and safely discontinuing opioids.”

Patient education is crucial to the process. Nurse practitioners can share their knowledge about the risks associated with opioid medications, including complications and consequences of abuse and misuse, with their patients and the communities they serve.

Ensuring Patient and Nurse Safety

Nurse practitioners can help health care facilities prescribe medications in a way that keeps patients and nurses safe. It is part of their responsibility to protect patients and themselves, but also the public, by adhering to state and national guidelines. These guidelines call for patient screenings and examinations, risk assessments, and informed consent. Timely and accurate documentation of these activities can help ensure nurse safety.

Adhering to best practices can protect nurses. For example, patient-provider agreements allow each person to understand their responsibilities and the consequences of drug misuse. The use of electronic medical records systems to note patient prescriptions and pharmacy prescription authorizations, while also maintaining copies of written orders where available, offers another level of nurse safety.

To protect patients, a nurse practitioner assesses the patient’s pain history, prescribes medication on a trial basis, and continually monitors the patient through diagnostic testing and risk assessments. While the patient is in their care, nurse practitioners evaluate reactions to treatments and develop treatment plans to address potential issues, such as incorrect or inaccurate prescriptions. By following best practices, nurse practitioners not only protect their patients from the risk of opioid addiction but also themselves in case of an investigation.

With their clinical expertise and focus on ensuring healthy patient outcomes, nurse practitioners are in an ideal position to ensure patient and nurse safety when prescribing opioid medications. These detail-oriented professionals have the advanced leadership, analytical, and critical thinking skills required to properly prescribe opioids. Their ability to listen and communicate enables nurse practitioners to educate patients and families about diagnosis, disease prevention, medications, therapies, and self-care.

Creating a Culture of Safety Through Advanced Nursing

Amid the current opioid crisis, and as health care systems face shortages of qualified professionals, advanced nurse practitioners can help strengthen the health care workforce. Nurse practitioners can address the growing need for health professionals who can provide prompt medical attention to those suffering from opioid overdoses. A CDC report examined hospital emergency department visits across 45 states and found a 30% rise in suspected opioid overdoses from July 2016 through September 2017.

A study published in Human Resources for Health found that advanced practice nurses in emergency rooms and critical care departments in hospitals can improve patient outcomes. According to the study, nurse practitioners delivered “emergency care services as timely as, if not faster than, physicians.” As a result, physicians in emergency departments can focus on patients with more complex medical needs, increasing and speeding up access to timely emergency care, the report suggests. Why is this finding important? It demonstrates the vital role of nurse practitioners in creating a culture of safety by delivering efficient care through advanced nursing.

For nurses seeking to make a more significant impact on the current opioid epidemic, Regis College offers its online BSN to DNP program. The program is designed to help nurses build the skills needed to ensure patient and nurse safety in various health care settings. Students enrolled in the program can select from five areas of concentration, including Psychiatric Mental Health. In hospitals, health clinics, and rehabilitation centers, psychiatric mental health nurse practitioners (PMHNPs)  use their clinical skills and knowledge of psycho-pharmacology to provide care to mental health clients, which can include working with substance abuse issues. Courses in the BSN to DNP program curriculum include the following:

Concepts in Nursing Leadership

A nurse practitioner seeking to lead fellow nurses in advancing nursing practice must understand the role of leadership to be effective. In this course, students learn about the theories and concepts behind leadership. They learn about the role leaders play in resolving conflicts, as well as about nursing leadership in the broader organizational context.

Health Policy, Politics, and Perspectives

National, state, and local health policies and reform options influence advanced nursing practice. Students enrolled in this course learn about U.S. health policy implementation and explore the health policy legislative process through a combination of classroom lectures and field experiences.

Regulatory Issues: Nurse Leadership

Students learn about health care administration and leadership through the prism of regulations. They explore current nursing research, evidence-based practice, and evolving health care trends. The course includes an analysis of current issues relating to the health care regulations and delivery systems that impact nursing practice.

Cultural Perspectives in Health Care

Health care providers must consider the cross-cultural perspectives of individuals, families, groups, and communities. This course explores the complex cultural factors inherent in the U.S. health care system and how they influence quality health care delivery. Students are exposed to theories and models that provide insight into culture and health for the general population and selected subsets.

Prepare for a Career Helping People Impacted by the Opioid Crisis

Nurses who seek to advance in their careers and promote safety for patients and nurses should explore the online BSN to DNP program offered by Regis College. Graduates of the program are prepared to make an impact in health care as nurse practitioners, tackling critical issues such as the opioid epidemic. Take the next step and learn how Regis College can help students build their careers as nurse practitioners.

Recommended Readings

What Is Vicarious Trauma? A Look at an Important Yet Overlooked Concept
The Importance of Developing Culturally Competent Health Care
Can You Earn a BSN to DNP Online with No GRE Scores?


American Association of Nurse Practitioners, Medication Safety and Pharmacology
American Hospital Association, Prescription Opioids: What You Need to Know
Centers for Disease Control and Prevention, “Emergency Department Data Show Rapid Increases in Opioid Overdoses”
Human Resources for Health, “The Impact of the Advanced Practice Nursing Role on Quality of Care, Clinical Outcomes, Patient Satisfaction, and Cost in the Emergency and Critical Care Settings: A Systematic Review”
The Journal of Nurse Practitioners, “Safe Opioid Prescribing for Adults by Nurse Practitioners: Part 2. Implementing and Managing Treatment”
Nursing Open, “Describing the Leadership Capabilities of Advanced Practice Nurses Using a Qualitative Descriptive Study”
Regis College, Course Finder
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
U.S. Department of Health and Human Services, “HHS Acting Secretary Declares Public Health Emergency to Address National Opioid Crisis”
U.S. Department of Health and Human Services, The Opioid Epidemic by the Numbers
U.S. Department of Health and Human Services, What Is the U.S. Opioid Epidemic?