You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.
Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.
Case Study Questions:
Analyze the case study for potential issues for members of the healthcare team from office conflict. Contrast the potential effects for each member of the healthcare team based upon the required readings from the week. Discuss the potential ethical and legal implications for each of the following practice members:
What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?
What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.
PLEASE ADD 2 POSSIBLE REPLIES TO DISCUSSION POST
The case study illustrates potential issues among staff members that can have a negative impact on patient’s safety. Conflicts are inevitable in the workplace. To prevent negative impacts of conflicts, sources of conflicts should be identified in advance, and ways of resolving the conflict put in place. Conflicts within healthcare teams may include harsh language such as threats and yelling, communication breakdown, or disruptive conduct. Conflict can be viewed constructively when used to solve disagreements and misunderstandings on tasks and roles. However, conflict may have a negative impact, such as a decrease in trust, team performance, and inefficient communication (Cullati et al., 2019). Conflicts in healthcare teams can draw the attention of health care professionals from patient care draining personal resources, increasing threats to patient’s safety, thus reducing the quality of care. From the case study, the Medical Assistant got distracted and failed to report the low blood pressure to the nurse practitioner. The attention was diverted to a heated argument putting the patient at risk since they required immediate attention.
The members of the health care team have contrasting effects from the scenario. the medical assistant is not affected directly as the liability of any errors, negligence, or malpractice is shouldered by the supervising physician or nurse practitioner. The nurse practitioner has direct liability. The medical director shoulders more liability as they bear the role of supervising, directing patient care, overseeing compliance, credentialing, and conducting chart review (Trulove, 2015).
Nurses are expected to act ethically while adhering to four ethical principles that include beneficence, autonomy, non-maleficence, and justice (Haddad & Geiger, 2018). The major ethical issue is patient negligence as the medical assistant neglected care to a patient, with the focus shifting to the argument. The medical assistant did not uphold the ethical principle of protecting the patient from harm as they delayed reporting the vitals in time, increasing the risk of harm to the patient. The ethical implication extends to the nurse practitioner as they shoulder the liability of the medical assistant. The medical director may have ethical implications related to patient safety due to the lack of a policy guiding conflict resolution in the workplace. The ethical and legal implication of a medical director is to enforce relevant policies to guide practice. Cases of conflict in the facility are not unusual, indicating a lack of proper policy. Legal implications may arise from neglecting the patient resulting in malpractice suits. Malpractice refers to incompetence or negligence on the part of the health care professional (Brock, Nicholson, Hooker, 2016). Major implications include penalties and revocation of the license. The legal implications can occur against medical directors, nurse practitioners, medical assistants, and practice.
To prevent further episodes that are potentially dangerous, I would adopt certain strategies such as defining acceptable behavior, staff education on conflict resolution, promote effective communication, and outlining disciplinary measures. The staff should be aware of the type of behavior acceptable within the organization despite differences from others. They should also be well informed on conflict resolution strategies such as collaboration, avoiding, accommodating, and compromising. Effective communication can mitigate conflicts.
A nurse practitioner is a clinical leader with the obligation to advocate for their patients. Leadership qualities that I would apply include effective communication and interpersonal skills and critical thinking skills. As a nurse practitioner, I am trained to influence others through collaborative efforts. Qualities stated facilitates the establishment of healthy relationships based on mutual respect and trust, increasing the potential to influence team members.
Possible Replies to the Discussion
I support that the case study provides a reflection of how conflicts affect performance in an organization and patient outcomes in health care facilities. A conflict can be a source of distraction from the professional roles and duties. The medical assistant in the case study was distracted by the heated argument with the colleague and failed to report low blood pressure to the nurse practitioner. Although the medical assistant was the one involved in the conflict and failed to report the patient’s vitals, the nurse practitioner and the medical director are equally responsible for incidence as the nurse practitioner is liable for the medical assistant and the medical director is liable for the facility. Ethical and legal implications for the practice members arise from patient neglect that can expand to a malpractice suit. Such implications include fines and penalties and licenses being revoked. To prevent such an episode, there should be a code of conduct. As a nurse practitioner, I would apply interpersonal skills to influence others towards ethical behavior.