NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

Chamberlain University NR 510 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 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 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 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 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

The introduction for the Chamberlain University NR 510 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 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 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 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 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 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

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 t

he 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

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Sample Answer 2 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

Since this is a detrimental mistake and issue, this would require a meeting with all the MAs and providers. However, I believe initially, there should be a private meeting with Stephanie to go over what exactly happened and a followup meeting to discuss the consequences of her action. Usually, when one makes a mistake on the unit I work for, it is brought up during monthly meetings or huddles because the management does not want staff to repeat the same mistake and cause more harm to the patient or even put their job and/or license at risk. For example, a nurse accidentally mixed two patient’s lab draw tubes and put it in one bag and sent it to laboratory. We never saw the actually meeting with the nurse, what the consequence was and management tried to not expose which nurse it was. However, thru gossip, the staff found out who. It was brought up in huddle several times to remind nurses to please remember to label lab draws correctly because this can cause patient harm if mislabeled or sent improperly to lab. I think having two staff meetings is appropriate because there should be one private meeting with Stephanie and another meeting with the staff as a whole to prevent this from happening again.

A good time to address Stephanie would be after the office has closed for the day (Young, 2014). I would not confront Stephanie directly. I would speak with the physician first to inform him/her of the situation (if he/she is not already aware of it) then request a meeting between the physician, myself, the hiring manager, and Stephanie. While it’s better to address workplace conflicts as soon as possible, sometimes help from a mediator will help eliminate further conflict (Young, 2014). I am an advocate of non-confrontational dialogues. Once the situation about Stephanie’s actions have been discussed in private with the persons involved and the appropriate disciplinary measures taken, a meeting with all the MA’s should be set up. This meeting is not to discredit Stephanie or inform the MA’s of Stephanie’s mistake but to retrain them in their scope of practice, remind them of the proper office procedures on how to handle difficult patient requests, and cover the laws regarding prescriptive authority (who is allowed to call in prescriptions and in what capacity).

Reference:

Young, M. O. (2014). Constructive feedback and disciplinary action. American Nurse Today, 9(4). Retrieved from https://www.americannursetoday.com/constructive-feedback-and-disciplinary-action/

Sample Answer 3 for NR 510 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.

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.

Sample Answer 4 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

Yes, I agree this can definitely be an awkward position to be in but I feel that going to Stephanie first to try to resolve my concerns will help to allow the situation to be less aggressive and I also feel this will cause less tension amongst us. I also felt that by going to her first, I would be able to get a better understanding of her thought process and she would be able to understand my concerns. Going to a supervisor or a manager first is not always the best option and can actually make things worse amongst co-workers. However, if she was to get defensive I would try to change the course of the conversation by first assuring her that I am not out to harm her but to make clear that my number one concern and priority would be to ensure the safety of my patients. I can definitely see that there is a strong possibility Stephanie would or could become defensive, but the conversation would not turn into an argument because it takes two people to argue and I would remove myself from the conversation for the time being to help de-escalate the situation. Removing myself for the moment would help allow the situation to calm down and allow her as well as myself to regather our thought to reproach the situation. Because this is a major concern and will need to be address, if going to Stephanie first does help resolve the issue I would then have no other choice to bring this matter to the supervising MD. I believe I can also help to try to change the course of the conversation to be more productive rather than argumentative by making sure my tone, body language and those essential non-verbal communication clues are not signaling aggressive or defensive signs.

Sample Answer 5 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One

You brought forth great information and ideas regarding this hot topic we are discussing. I agree, Stephanie not only put the patient at risk, but the NP, MD and practice as a whole with her actions. I think most of us agree that she probably thought she was helping both the patient and the NP, however quite the opposite took place. She is very lucky that the patient did not have an adverse reaction to he medication, and for all we know this “persistent” patient may have told Stephanie that this particular antibiotic worked well for her in the past. None the less, Stephanie should not have taken things into her own hands, and should always consult the licensed prescriber that she is phoning medications in under first, under any and all circumstances, no matter how trivial they may seem to her. As I mentioned in a previous post, I myself was a medical assistant for many years prior to becoming a nurse. I had a great relationship with the physicians I worked with, and they trusted me with many things, including phoning in medications for them. We had a great system down, I would help sort through the messages, placing the most important ones on top (such as ill patients asking for medication), and the MD would write what he wanted done, such as patient needs to be seen, or the name of the medications he wished to be phoned in. The MD would always sign his name/initials on the message as well, as a means of authorization. I would then phone the patients that he wanted to be seen so that they can come in for a visit, then I would phone in any authorized prescriptions. We typically performed these tasks between patients in effort to keep both the in person patients waiting to be seen, and the high influx of phone calls, running as smooth as possible. We were always busy, but we had a good system in place, and trust me- we had many “persistent” patients who wanted to have their way or got mad at us if they didn’t get their way as far as medications being phoned in. No matter how busy or behind we were, I never took matters into my own hands without first speaking with the MD. So, if Stephanie attempts to say she was trying to not bother the NP or was trying to save time, this is still no excuse for going outside of her scope of practice. In addition, this cough that the patient has could be viral as many are, or simply not an infection at all. What if it is a side effect from one of her existing medications, or due to a heart issue? These are the considerations that would be taking place with a licensed practitioner, which is ultimately for them to decide what is in the best interest of the patient, the prescriber and the practice.

NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One