NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
Chamberlain University NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
Whether one passes or fails an academic assignment such as the Chamberlain University NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
The introduction for the Chamberlain University NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
After the introduction, move into the main part of the NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
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 is your next logically sound course of action? Provide evidence to support your response.
My immediate action is to address the patient’s reason for the visit. According to Mitchell and Oliphant (2016), I have a responsibility to conduct a comprehensive patient interview or consultation before prescribing any medications. While there are ethical issues with what Stephanie did, even though her intentions were good, this must be addressed in private later. Mrs. Smith has already taken a prescribed dose of amoxicillin for her cough. If the amoxicillin has not cleared up the cough, I should not provide her with a refill order just yet. This may have been the wrong medicine to prescribe for a cough in the first place. For one, if Mrs. Smith felt comfortable with Stephanie calling in a prescription order without the doctor’s consent, this may not be the first time she has been prescribed an antibiotic without being checked-out first. Mrs. Smith may have developed a resistance to the antibiotic. Norris et al. (2013) state antibiotic resistance is a serious, growing threat that causes the bacteria in patients’ bodies to become immune to the antibiotics medicinal properties. Many respiratory conditions are viral infections not bacteria-based illnesses, and Mrs. Smith may not have known that antibiotics only work against bacteria. There are many possible factors as to why Mrs. Smith has developed a chronic cough. I should conduct her physical exam and ask her questions about her cough (when it developed, the type of cough like wet or dry, does the patient smoke, any shortness of breath, has she taken any medication other than amoxicillin to treat the cough). I should then draw Mrs. Smith’s blood to send to lab for testing to determine if she has become resistant to amoxicillin. Also, during her physical, I can see if movement or exertion prompt her to cough. Once the physical has been performed and cough symptoms evaluated, I will take medications, past health history, and any present conditions I have recognized during the physical into consideration then decide on the best cough treatment plan. Once the patient has been taken care of, I will create thorough notes to document the visit, my findings and actions, and Stephanie’s actions then report what has occurred to the primary physician and office manager.
Reference
Mitchell, A., & Oliphant, C. M. (2016). Responsibility for ethical prescribing. The Journal for Nurse Practitioners, 12(3), A20. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2016.01.008Links to an external site.
Norris, P., Chamberlain, K., Dew, K., Gabe, J., Hodgetts, D., & Madden, H. (2013). Public beliefs about antibiotics, infection and resistance: A qualitative study. Antibiotics, 2(4), 465-476. doi:10.3390/antibiotics2040465
Sample Answer 2 for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
For this case study, I feel that having a prescription or any medication ordered and placed under my name is a major concern, especially seeing that it was not order with a provider’s judgment. My view regarding this case study may seem strong however; this may be related to the fact that I am currently learning and developing a foundation and understanding of the roles, function, and scope of practice of an advance-practicing nurse, family nurse practitioner. According to Gregory (2014), regardless of the years of services of a medical assistant, they are not allowed to prescribe medication to clients. In fact, depending on the state laws and facility policy that the medical assistant is working, they may be allow to telephone prescriptions to the pharmacy, assess and record vital signs, and report acute, abnormal lab such as glucose findings to nurses. However, they are not allowed to prescribe any form of medication as this is not within their scope of practice and is considered unethical and unlawful (Hoke and Hexem, 2017).
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Furthermore, because both the medical assistant and the nurse practitioner know that prescribing medication under the name of a provider without appropriate orders is unlawful and unethical, I do believe that the next logical sound course of action would be to discuss disciplinary action with the medical assistant. I do not think is an extreme measure due to the years of experience of the medical assistant has, she should definitely know what is lawful and ethical within his or her job description. I actually see and hear of similar situations to this case study in my place of employment, as far as employees practicing or implementing interventions out of their scope of practice and job description. I have personally experience nurse assistants attempt to carry out and delegate Registered Nurses interventions and orders that were outside of their job description. However, I have not witness to the extent of a medical assistant ordering and prescribing a medication under a nurse practitioner or doctor.
In addition to the disciplinary action that I would hold to the medical assistant, I would also reinforce the practice expectations as to what is within their scope of practice/job description including the policy and procedure. I feel this is essential because if nothing the assistant is not held accountable or if the issue is not address regarding her unlawful and unethical actions the next situation could be worse. This is a serious matter because regardless of the rapport and years of experience she has still does not hold the sound judgment and competence of an advance-practicing nurse nor a physician to make such a decision.
Reference
Gregory, M. (2014). Researching the Scope of Practice for Medical Assistants. AAACN Viewpoint, 36(2), 13-14.
Hoke, K., & Hexem, S. (2017). Expanding Access to Care: Scope of Practice Laws. Journal Of Law, Medicine & Ethics, 4533-36. doi:10.1177/1073110517703316
Sample Answer 3 for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
I am glad that you brought up looking at Stephanie’s reasoning or mindset about the situation. I think you are right that Stephanie was trying to help or avoid a confrontation with the patient, but Stephanie’s decision definitely made the situation worse instead of better. I cracked up about your comments regarding the patient who wrote a letter to the president of the hospital for not receiving an antibiotic for dehydration. That patient should be writing the president a thank you note for your great nursing. What this patient did not realize is that a possible side effect to taking antibiotics is diarrhea. If not monitored properly, diarrhea can cause severe dehydration. Today, patients are so quick to file lawsuits against doctors and nurses if they do not get their way or if the outcome of the medical procedure is not what they expected it to be. Is there a solution to minimizing the number of medical lawsuits filed per year? After researching my own question, I came across an article that discusses the profile of patients most likely to file litigious claims. The article states, respecting patients’ need for information during clinical consultations and disclosing medical errors when they occur is the more patient-centered approach and the best way to lessen the likelihood of a claim (Tsimtsiou, 2014). The point of this statement is that medical staff need to be more forthcoming to patients instead of trying to please them. If Stephanie had politely informed the patient that she would have to wait until her appointment to discuss her refill request for the antibiotic, noted the patient’s file, and forwarded the patient’s request to the NP assigned to the patient, Stephanie would have followed protocol and taken a patient-centered approach.
Sample Answer 4 for NR 510 dq 1 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
It is extremely important to keep the integrity of the team at the office in good standing despite this breech of scope of practice. I agree it must be approached very professionally as the conversation can go two ways, either helping build the relationship of the professionals or cause “hostility, emotionality and distraction”(Greer,et al. 2012) from the true problem at hand. No one likes to be wrong and be blamed but if approached in the right way with the patients best interest kept as the main focus of the conversation it should be well received. It can be presented with the physician, NP, and MA in private as a conversation starting with all of the good attributes of the MA then lead into everyone’s understanding about roles and scope of practice. I doubt, but she may not have realized how wrong this action was but it is possible and should be taken into consideration.
Greer, L. L., Saygi, O., Aaldering, H., & de Dreu, Carsten K. W. (2012). Conflict in medical teams: Opportunity or danger? Medical Education, 46(10), 935-942. doi:http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.1111/j.1365-2923.2012.04321.x
References
Tsimtsiou, Z., Kirana, P., Hatzimouratidis, K., & Hatzichristou, D. (2014). What is the profile of patients thinking of litigation? Results from the hospitalized and outpatients’ profile and expectations study. Hippokratia, 18(2), 139–143.
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate
program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
☐ The title page is present. APA format is applied correctly. There are no errors.
☐ The introduction is present. APA format is applied correctly. There are no errors.
☐ Topic is well defined.
☐ Strong thesis statement is included in the introduction of the paper.
☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.
☐ All sources are cited. APA style and format are correctly applied and are free from error.
☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.
Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.