The FNP treated a patient's back pain with Vicodin for several months. However, the FNP began to suspect the patient was drug seeking when the patient's stories about lost/damaged Vicodin prescriptions seemed implausible. The FNP investigated and found the patient was getting prescriptions from multiple providers. The FNP did not renew the prescription and reported the patient to the pharmacy board.

1. The Drug Seeking Patient Shelley Ross BS, RN California State University, Dominguez Hills Division of Nursing Nursing Ethics MSN 531 Kathleen F. O’Connor, PhD, RN, CNE December 4. 2008

7. ACA 7 Steps to Decision Making (Forester-Miller, & Davis, 1996) 1. Identify 2. Apply 3. Determine 4. Generate 5. Consider 6. Evaluate 7. Implement Identify the problem Apply Code of Ethics Determine the nature and dimensions of the dilemma Generate potential courses of action Consider potential consequences of options, choose course of action Evaluate the course of action chosen Implement the selected course of action, and evaluate results

8. ACA Decision Making Process By FNP 1. Identify 2. Apply 3. Determine 4. Generate 5. Consider 6. Evaluate 7. Implement Patient’s story did not match up Considered the nursing code of ethics Dishonest patient, illegal act, drug abuse problem Decline or renew prescription? Please patient and potentially feed a drug problem or investigate first and help prevent drug dependence FNP considered consequences to options FNP investigated, reported findings to pharmacy board, patient failed to return to clinic