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1. What are the potential ethical and legal implications for each of the following practice members?

Medical Assistant

The medical assistant (MA) Stephanie over crossed her scope of practice as a MA in the state of Illinois. A medical assistant is a qualified professional who assists the doctor or nurse practitioner in a clinic with both administrative and medical procedures. An MA receives certified by the state not a license therefore, an MA’s has no state regulations but must follow rules of ethics and a set of legal guidelines set forth by each state. The potential ethical and legal implication for Stephanie would be that she took a call from a patient and called in a prescription to the pharmacy without a provider’s approval for the prescription. As an MA, Stephanie does not have the pharmacological training, the licensure, or the legal authority to evaluate the patient for a prescription or a refill without approval first. This MA did violate an ethical code, possibly because she felt prescribing an antibiotic was no big deal especially since she was familiar with the patient. This patient could develop an antibiotic resistance particularly since she was trying to refill the amoxicillin that was just filled last week. Antibiotic resistance has been a growing concern as a public health concern, patients think antibiotics cures all. Antibiotics are being used and misused which is increasing the probability of antibiotic resistance globally, actions need to be taken to reduce the unnecessary use of antibiotics (Smith, M’ikanatha, & Read, 2015). If Stephanie filled this prescription, who’s to know how many other patient’s prescriptions she filled without consent from the provider.

Nurse Practitioner

As the nurse practitioner, that name is on the amoxicillin bottle, you could face legal matters since you did not actually prescribe this medication. When a provider prescribes a medication, they should be following a standard of care to ensure that every medication prescribed is safe and compatible with other medications a patient takes. If Mrs. Smith was taking a medication that was not compatible with amoxicillin but Stephanie did not know that it could have caused a major drug interaction for this patient. This action from Stephanie put the nurse practitioner’s license in jeopardy and put Mrs. Smith at risk for serious medical harm. As a nurse practitioner ethically and legally, you have a moral obligation to protect your patients and not causing harm to them.

Medical Director

The medical director is the physician leader who provides the guidelines and protocols to the clinical staff which includes the nurse practitioner and the medical assistant. A legal implication for the medical director could be if a medical error occurred with Mrs. Smith, she could potentially hold the medical director and practice responsible for any damages that occurred to her. The medical director would be the one who describes why the medical assistant used the nurse practitioner’s name to fill a prescription for Mrs. Smith without the approval of the NP.

Practice

The practice could face legal and ethical consequences that could affect clinical and organizational operations. If this patient was harmed by taking this prescription then she could sue for medical malpractice. A malpractice lawsuit you must be able to prove your provider caused harm or negligence in connection with your diagnosis or treatment. In this case, if Mrs. Smith did have harm from taking the amoxicillin, she could have a malpractice claim against the practice, especially since a MA is the one who prescribed the medication without proper consent.

2. What strategies would you implement to prevent further episodes of potentially illegal behavior?

As a nurse practitioner, you become a strong leader and good communicator not only for your patients but also for your health care team. The strategies as an NP in this practice that I would implement to prevent further potentially illegal behavior would be to help organize an organizational and clinical restructuring. This would include implementing new technology that would require a provider’s signature or personal ID before a medical assistant could send a prescription to a pharmacy. I would also recommend the organization to look at the culture of practice, many of the employees could base their practice on outdated guidelines or protocols. Stephanie has been here for 10 years; she has the knowledge and the work experience but maybe overlooking important steps of her job description. Medical assistants are an important part of any practice, each one offers different skills and abilities. It is beneficial to offer training to standardize skills for MAs, this would include refreshing basic knowledge or retraining in higher-level tasks (Eden, 2016). Providing all the medical assistants in this office with continuing education and regular workshops can help with the current demands of the everchanging healthcare field.

3. What leadership qualities would you apply to effect a positive change in the practice?? Be thinking about the culture of the practice.

A good leader is someone who can inspire others to work together in pursuit of a common objective, such as improve our patient’s experience. As one of the nurse practitioners in this practice, it is important to be a leader for my fellow employees through compassion, courage, enthusiasm, and communicating expectations clearly. Everyone in this practice is a part of a healthcare team and each one of them is a valuable part of this team. One way I could focus on change within the culture of the practice would be to follow a management style called transformational leadership. The components of transformational leadership are to recognize staff and create a meaningful environment that employees feel valued but also want to deliver high-quality care for patients (Mennella & Pravikoff, 2018). This concept helps motivate the team by encouraging them to strive to make themselves and the practice a safe and reputable place to work.

Eden R. S. (2016). Maximizing Your Medical Assistant’s Role. Family practice management, 23(3), 5. PMID: 27176095

Mennella, H., & Pravikoff, D. (2018). Transformational Leadership in Nursing. Retrieved 2020, from Nursing Reference Center Plus. doi: T903558

Smith, R. A., M’ikanatha, N. M., & Read, A. F. (2015). Antibiotic resistance: a primer and call to action. Health communication, 30(3), 309–314. https://doi.org/10.1080/10410236.2014.943634