‘Trigger shot’ administration in emergency departments: What are the issues?

Abstract

Assisted reproductive and other technologies present ethical dilemmas and practical challenges to nurses and other health care providers. The administration of drugs, such as Human Chorionic Gonadotrophin (commonly known as ‘trigger shots’) by nurses in emergency departments is an issue that has not been addressed. Women receiving treatment for infertility who present to emergency departments requesting a nurse administer a ‘trigger shot’, cannot usually provide a legal drug order. When faced with this situation, emergency nurses need to make a prompt decision about giving this injection (or not) because timely administration of this drug is paramount to the success of the reproductive cycle. There are resource and legal implications of complying with such requests, however refusal to administer these drugs to women who are in the midst of rigorous treatment for infertility, poses an ethical dilemma for nurses. The problem usually arises when women who are dependent on others to administer their medication need this medication outside normal clinic hours. Infertility clinics could assist in providing a solution to this problem by liaising with providers situated close to the residence of distant clients and pre-arranging care management. Solutions in metropolitan areas may be provided by the appointment of an after hours nurse to administer the drugs prescribed for the woman as part of their assisted reproduction program, and amending current practice to ensure that women are provided with a legal prescription or drug order. A part from providing women with timely and appropriate care, this would reduce the legal and resource implications associated with presenting to emergency departments for administration of prescribed ‘trigger shots’.