Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study

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.

Discussion Question:

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.

Solution:

There are various potential ethical as well as legal implications for a plethora of practice members in this scenario. In this consideration, in regards to the medical assistant, prescribing medication to Smith without informing the nurses or physicians is unethical to a huge extent. Besides, indicating my name as the prescriber can also be considered as unethical and illegal. Taking this into consideration, by doing so, the medical assistant is likely to compromise the image of the healthcare facility. It is also deducible that the medical practitioner risks losing her job. In relation to the nurse practitioner as well as medical directors, unethical prescription by the medical assistant means that their roles in the facility are being conducted by a person an unauthorized individual. This, again, may make the facility lose credibility in the eyes of the patients. This is attributed to the fact that the healthcare practice in the facility is jeopardized to a considerable extent.

On the basis of the delicate nature of the situation, I would first consider investigating the issue by summoning Stephanie the reason behind prescribing medication to Smith. From this point, I would caution Stephanie to never do that, and in the event, I cannot be reached, she should consult another nurse of the provider. According to Kartha et al. (2014), it is…Please click the icon below to purchase full answer at only $10