NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Chamberlain University NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two 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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Whether one passes or fails an academic assignment such as the Chamberlain University NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two 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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
The introduction for the Chamberlain University NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two 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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
After the introduction, move into the main part of the NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two 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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
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 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Upon further investigation, you learn that Stephanie spoke with the patient and called the medication into the patient’s pharmacy without consulting with a provider. Stephanie claimed that the patient was insistent about needing a prescription. Because Mrs. Smith was coming into the office the following week for an appointment, she didn’t think you would mind if the patient received the prescription early.
Discussion Question:
What are the ethical-legal concerns associated with this situation? What is your liability in this situation, if any? What is the practice’s liability in this situation? What quality improvement strategies might you implement as an APN in this practice to safeguard your role and assure patient safety? Provide evidence to support your response.
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Like I stated in Part 1, this can be a serious matter even if the patient is not physically harmed. Since Stephanie is the medical assistant, placing and verifying orders are not in her job description. Even as I am now as a bedside nurse, placing orders without proper verification from a MD/NP/DO would land me in some trouble if this happened.Only nursing orders, like IV pump, heating pad or basic equipment/care can be placed by the nurse at the hospital I work at.
As an NP in this situation, I do not think that the NP is held liable. If a nurse places an order and document that it was verified by the MD, but thru investigation it was found that it was not, the MD is not held liable. The same should go for the NP. The nurse would be reprimanded for doing that and the MD will not held liable or be found at fault. In school for each profession, one is taught what they can and cannot do within legal limits. Stephanie got comfortable and thought it was go to go outside of her job description that I am sure she already knows. The practice as a whole may be liable, especially if harm was done to the patient. The principle of non-maleficence (to do no harm) states that a health care professional should act in such a way that he or she does no harm, even if her or his patient or client requests this. Stephanie may have not had bad intent and was thinking she was probably helping in this situation to alleviate some of the work for the providers and NPs. Also, she probably thought she was making it more simple for the patient. However, this could cause harm to the patient as a NP or MD must assess if and why a new antibiotic must be ordered in the first place. Also, the practice is responsible and must be held liable of alerting Mrs. Smith of the situation so the he knows what he going on. This maybe the hardest part as Mrs. Smith might lose trust in the practice, place a bad review and can have the right to sue the facility even if no physical harm was done. Negligence can be seen as failure to take reasonable care or steps to prevent loss or injury to another person. Nursing negligence is when a nurse who is fully capable of caring does not care in the way a reasonably prudent nurse would, and as a result the patient suffers unnecessarily. Even though this was not directly a nursing issue, she can still sue for negligence. Mrs. Smith may do nothing at all once told if she feels strongly tied to the practice. However, it is completely up to Mrs. Smith how she wants to go about the issue. If she decides to take it that far into suing the practice, Stephanie might be at risk to lose her job as she now becomes a liability to the practice. There is many ways this situation goes depending on the outcome. (Tinnon, 2017)
To prevent that issue, maybe the medical assistant can only have access to certain parts of the program. For example, maybe when it comes to prescriptions, the medical assistant can not print out or issue it out to the patient till the NP/MD signs off and verifies it. The program should stop her from issuing it to the patient without proper verification. For example, in the hospital setting, even if the program is the same name, each profession has their own set customized for their job description. A nurse’s screen will look different from a PCA, unit secretary or a respiratory therapist. With this setup, one can only access what is felt is allowed for the specific job description. (Schub & Kornusky, 2016)
Reference:
Schub, T. B., & Kornusky, J. M. (2016). Standing Orders, Order Sets, and Protocols: Government Regulations. CINAHL Nursing Guide,
Tinnon, E (2017). Situational awareness and Nursing Code of Ethics. Nurse Educator, 43(1), 32-36.
Sample Answer 2 for NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
In this weeks reading, we learned about the legal scope of nursing practice and how to solve ethical dilemmas. Thankfully Stephanie was honest and admitted what she did. In a healthcare dilemma that is probably seen far too often, Stephanie was in the wrong for assuming the prescription was ok without consulting me. Patients can be pushy, but Stephanie could have either set Mrs. Smith up with a same-day appointment, have her come in a day or two to be seen early, or at least checked with the on-call physician or Nurse Practitioner in the practice to see if the prescription was ok. The first legal concern is a medical assistant prescribing. The role of a Medical Assistant is to escort patient, take vital signs, and write down the chief complaint in the medical record (Chapman & Blash, 2017). Prescribing is outside of her scope of practice. The ethical dilemma is reporting a hard-worker or not for trying to help you out. This may be her first offense, but she should know better, especially with ten years experience, that she was acting outside her job description. Telephone prescribing is risky due to lack of physical assessment, testing for infections, and the possibility of over-prescribing antibiotics (Ewen, Willey, Kolm, McGhan, & Drees, 2015). An antibiotic for a cough is probably useless and could potentially lead to yeast infections or lead to antibiotic-resistant infections, doing Mrs. Smith more harm than good. I am liable for this situation because my name is on the prescription, and any harm to the patient could be a negligence or malpractice suit. I should also follow up with all of my patients and their symptoms. I also need the correct coding and documentation for billing purposes. Things need to be appropriately documented. Depending on the state of practice and the ability of the physician to delegate NPs to prescribe, the practice could also be seen liable. The practice should also oversee the hiring and firing of employees as well as making sure people are in their scopes of practice. A good way to safeguard my role would be to not prescribe via telephone. Although more time consuming, physically assessing my patients and testing for illness before I prescribe medications is safer for my license and my patients.
Chapman, S. A., & Blash, L. K. (2017). New roles for medical assistants in innovative primary care practices. Health Services Research, 5(2), 383-406. doi:10.1111/1475-6773.12602
Ewen, E., Willey, V. J., Kolm, P., McGhan, W. F., & Drees, M. (2015). Antibiotic prescribing by telephone in primary care. Pharmacoepidemiology And Drug Safety, 24(2), 113-120. doi:10.1002/pds.3686
Sample Answer 3 for NR 510- dq 2 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Further investigation reveals that Stephanie deliberately falsified a prescription for Mrs. Smith, although her intentions were “good”, it does not make her actions acceptable and Stephanie should face consequences. One might argue that the situation calls for Stephanie to lose her job and legal actions be taken, therefore legally Stephanie should lose her job and receive additional legal consequences for falsifying a prescription. Yet, Stephanie has been a loyal and good worker for the past 10 years. She made a mistake by thinking she had the authority to call in a prescription without consulting a provider. Situations like these may bring into question ethical, moral and legal issues and make it difficult to resolve the situation. Being emotionally intelligent allows the Nurse Practitioner to be a successful leader by using self-awareness, empathy, management of emotions and people skills (Ramsay, 2001). Strategies such as open and direct communication, respect, working as a team to find a solution and humility are ways to resolve the ethical-legal dilemma presented in this situation (Brown, 2012). Surely, we all agree Stephanie did wrong and there should be consequences, yet is it necessary for her to be charged and possibly do jail time? And I think all of us as nurses know how hard we have worked to get out license and running the risk of losing it and not only that but the possibility of facing jail time if the patient had been harmed with the prescription. It easy to want to have empathy for Stephanie considering the relationship with the clinic but ultimately her saying sorry can’t get you yours license back if it had lead to you losing it. I think a way that the nurse practitioner can ensure their role and promote patient safety would be to each day review all prescriptions made under her name and verify that the orders placed are orders that they placed. This might take more time but we can never be too safe when it comes to protecting our license. Currently there are no policies addressing non-urgent patient requests for prescription. According to Hughes (2008), medical errors are more often a result of systems and processes and not individuals (Hughes, 2008). An important quality improvement strategy is interprofessional communication and communication skills, which evidently lacked between the MA and Nurse Practitioner. The APN should be promptly informed of any patient calling to request non-urgent prescriptions or refills so he/she can further assess the situation and decide if the patient needs an office visit or may receive a prescription. If the NP is not available the patient should be informed they will receive a call back once the provider is available. Proper communication skills should always be followed and every patient request should be followed through. According to Moore and Reynolds (2013), effective and compassionate care is achieved through strategic communication, yet very few healthcare workers are trained properly in communications skills (Moore & Reynolds, 2013).
Reference:
Brown J., Lewis, L., Ellis, K., Stewart, M., Freeman, T., Kasperski J. M., (2012). Conflict on interprofessional primary health care teams – can it be resolved? Journal of Interprofessional Care, 25, 5-10.
Ramsay, M. A. E. (2001). Conflict in the health care workplace. Proceedings (Baylor University. Medical Center), 14(2), 138–139.
Moore, C. D., & Reynolds, A. M. (2013). Clinical Update: Clinical Update: Communication Issues and Advance Care Planning. Seminars In Oncology Nursing, 29(Cognitive Changes Associated with Cancer and Cancer Treatment), e1-e12. doi:10.1016/j.soncn.2013.07.001
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