Organizational Change and Ethical – Legal APN
You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.
Case Study Questions:
What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
A scholarly resource must be used for EACH discussion question each week.
Sample Paper
Organizational Change and Ethical – Legal APN
What are the potential ethical and legal implications for each of the following practice members?
Medical Assistant
The potential ethical issues related to the case study highlighted above in which a medical assistant administers medication to a patient under the disguise that she has been directed by the family nurse practitioner relates to beneficence and nonmaleficence. By virtue of not being qualified to attend to patients and prescribe medications, the medical assistant goes against the ethical principle of beneficence, which highlights that healthcare providers should only perform procedures and actions that will be of direct benefit to patients (Priestman, 2017). The medical assistant also goes against the ethical principle of nonmaleficence, which highlights that health care providers should not be involved in any actions that can bring Direct harm to the patients by administering amoxicillin patient the medical assistant endangers the life of the patient because she does not possess the knowledge and experience to understand the patient’s symptoms adequately and prescribe medication.
On the other hand, the potential legal implications for the medical assistant relate to her personal liability for malpractice. In case of any adverse effects related to the administration of amoxicillin, the medical assistant can therefore be held personally liable for their actions if the patient decides to file a malpractice lawsuit against the health care facility (Kadivar et al., 2017).
Nurse Practitioner
On the other hand, the potential ethical implications for the nurse practitioner relate to nonmaleficence. This ethical principle highlights that a nurse practitioner should not be involved in any action that brings direct harm to a patient. The wrongful administration of medication by a medical assistant using the nurse practitioner’s name can therefore cause direct harm to the patient (Priestman, 2017).
The potential legal implications to the nurse practitioner relate to substituted liability where are superior in a healthcare environment will be accountable for the negligent acts of their subordinates (Dudley et al., 2020).
Medical Director
The potential ethical implication for the medical director relates to beneficence in that the medical director should ensure that the patients always receive medications and procedures that benefit their health directly in a healthcare facility.
On the other hand, the legal implications related to the medical director relate to corporate liability, where the institution has the accountability and responsibility of maintaining an environment that promotes safe and quality health care to all patients (Wagner, 2018).
Practice
The ethical implications of practice related to the case study are based on the principles of beneficence and nonmaleficence. All Healthcare providers involved in providing healthcare services should always act in the best interest of the patient (Dudley et al., 2020). On the other hand, the legal implications for practice include malpractice, with patients having the right to sue healthcare facilities for malpractice in instances where they experience avoidable adverse outcomes (Kadivar et al., 2017).
What strategies would you implement to prevent further episodes of potentially illegal behavior?
The strategies that could be implemented to prevent further incidences of potentially illegal behavior, such as a medical assistant administering medication to patients, would include coming up with a clear definition of roles and duties and a clear delegation plan and providing and providing such a plan to all health care providers involved in attending to patients. Training and education of all health care providers on their roles and duties and understanding the delegation plan would also help to reduce future episodes of illegal behavior (Dudley et al., 2020).
What leadership qualities would you apply to effect a positive change in the practice?
The transformational leadership style that promotes open communication and encourages innovation would play a significant role in affecting a positive change in the practice. The transformational leadership style helps to promote an open and collaborative culture in practice which would play a significant role in preventing episodes of illegal behavior (Priestman, 2017).
References
Dudley, N., Miller, J., Breslin, M. L., Chapman, S. A., & Spetz, J. (2020). The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study. Medical Care Research and Review, 78(1_suppl), 47S-56S. https://doi.org/10.1177/1077558720960902
Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical and legal aspects of patient’s safety: a clinical case report. Journal of medical ethics and history of medicine, 10, 15.
Priestman, T. I. (2017). Delegation and the legal, professional and ethical issues for veterinary nurses: a case study. The Veterinary Nurse, 8(4), 226–229. https://doi.org/10.12968/vetn.2017.8.4.226
Wagner, E. A. (2018). Improving Patient Care Outcomes Through Better Delegation-Communication Between Nurses and Assistive Personnel. Journal of Nursing Care Quality, 33(2), 187–193. https://doi.org/10.1097/ncq.0000000000000282
