What are the potential ethical and legal implications for each of the following practice members?
Medical Assistant (Stephanie):
When Stephanie attended to the patient’s medical issue and administered medication without appropriate authorization, the medical assistant exceeded her designated responsibilities, potentially raising ethical concerns. The act of prescribing medication without proper authorization is not within the medical assistant’s scope of practice and is unlawful, contravening state regulations (Spetz et al., 2019). Such actions could lead to legal ramifications for Stephanie, myself as the prescribing practitioner, and our practice.
Nurse Practitioner (Myself):
Being the designated prescribing provider raises ethical issues when medication is prescribed without authorization. This action may be interpreted as a failure to adequately document and communicate with other care team members, potentially breaching ethical responsibilities. Unauthorized prescribing carries legal repercussions, such as disciplinary measures from the state licensing board or possible malpractice claims in cases of harm resulting from the prescription (Perloff et al., 2017).
Medical Director:
The medical director bears the duty of guaranteeing that all practice members comply with both legal and ethical standards. Neglecting to rectify potential problems such as unauthorized prescribing or inadequate internal communication could be interpreted as an ethical failing. Should it be established that there was a lapse in monitoring or supervising the medical assistant’s conduct, the medical director may encounter legal repercussions, potentially including liability for the actions of practice staff.
Practice:
The complete responsibility lies with the practice to ensure that all patient care activities are conducted within its authorized limits and comply with legal and ethical standards. Failing to address issues such as unauthorized prescriptions in this scenario or communication breakdowns could damage the practice’s reputation and undermine patient confidence. There is a potential for legal consequences, including potential liability for the actions of staff members like Stephanie and, indirectly, myself as the provider. Ramifications may involve regulatory penalties, financial fines, or legal claims from patients harmed by unauthorized prescriptions (Perloff et al., 2017).
What strategies would you implement to prevent further episodes of potentially illegal behavior?
Detecting potential illegal behavior in the workplace, such as unauthorized prescription refills, demands immediate attention and action to forestall further incidents. An investigation must be promptly initiated to delve into the matter comprehensively. Stephanie will be interviewed to gather her perspective and appropriate disciplinary measures will be taken (Martin & Alexander, 2019) concerning the specific incident involving Mrs. Smith’s prescription refill. Possible actions may include counseling, retraining, or disciplinary actions, depending on the severity of the violation and any prior occurrences.
A comprehensive review of existing policies and procedures regarding prescription refills and patient interactions will be conducted with all staff members. This review aims to underscore the importance of adhering to established protocols and to ensure that all staff members are fully informed about them. Furthermore, additional education and training will be provided to all staff, including medical assistants, regarding the correct procedures for handling prescription requests and patient interactions (Martin & Alexander, 2019). Special emphasis will be placed on elucidating the legal and ethical ramifications of unauthorized prescription refills.
What leadership qualities would you apply to effect a positive change in the practice?
To safeguard against any alteration in the rapport between medical assistants and patients/staff, there will be a concerted effort to cultivate a culture of compliance and integrity within the practice (Denisco & Barker, 2015). This would entail valuing and rewarding ethical behavior, and encouraging staff members to uphold professional standards and ethical principles in all their interactions with patients and colleagues.
References
Denisco, S. M., & Barker, A. M. (2015). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.
Martin, B., & Alexander, M. (2019). The Economic Burden and Practice Restrictions Associated With Collaborative Practice Agreements: A National Survey of Advanced Practice Registered Nurses. Journal of Nursing Regulation, 9(4), 22–30. https://doi.org/10.1016/s2155-8256(19)30012-2
Perloff, J., Clarke, S., DesRoches, C. M., O’Reilly-Jacob, M., & Buerhaus, P. (2017). Association of State-Level Restrictions in Nurse Practitioner Scope of Practice With the Quality of Primary Care Provided to Medicare Beneficiaries. Medical Care Research and Review, 76(5), 597–626. https://doi.org/10.1177/1077558717732402
Spetz, J., Toretsky, C., Chapman, S., Phoenix, B., & Tierney, M. (2019). Nurse Practitioner and Physician Assistant Waivers to Prescribe Buprenorphine and State Scope of Practice Restrictions. JAMA, 321(14), 1407. https://doi.org/10.1001/jama.2019.0834
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