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 exist various potential ethical and legal implications for various practice members in this scenario. Taking this into consideration, when it comes to the medical assistant, prescribing medication to Smith without informing the physicians or the nurses is unethical. Additionally, indicating my name as the prescriber is can also be regarded as unethical and illegal.  By doing so, the medical assistant is likely to compromise the reputation of the facility. The medical practitioner also risks losing her job. When it comes to nurse practitioner and medical directors, unethical prescription by the medical assistant implies that their roles in the facility are being conducted by a person who is not authorized…Please click the icon below to purchase full solution at $5