Case Scenario-Ethical and Legal Implications

Case Scenario-Ethical and Legal Implications

The scenario involves a medical assistant, a nurse practitioner, and a medical director working in an extensive hospital system that has been in practice for over 15 years. Most staff members have worked in the hospital since it was opened, while the nurse practitioner has worked there for less than three months. Since the nurse practitioner began working at the hospital, she has witnessed several staff members have arguments. On this specific day, the nurse practitioner overheard an argument between the medical assistant and another staff member. The nurse practitioner looked at a patient’s chart and noticed a recording of low blood pressure that the medical assistant had not informed the nurse practitioner about. The nurse practitioner confronted the medical assistant, who disclosed that she got involved in a heated argument and forgot to report the patient’s vital signs, such as the patient’s low blood pressure reading.

Potential Ethical & Legal Implications for Healthcare Team Members

The behavior and practice of healthcare team members influence patient outcomes. The relationship between healthcare team members dictates their ability to work together in the spirit of teamwork. Healthcare members must practice teamwork to ensure good patient outcomes since their legal and ethical responsibility requires ensuring patient safety and good patient outcomes. The healthcare team members in this scenario include a nurse practitioner and a medical assistant. Every healthcare cadre has a specific job description, code of conduct, and ethics that guide their practice. General ethics and legal guidelines cover the practice of all healthcare members regardless of their cadre (Young & Wagner, 2022). Hospital management has policies that are specific to their staff members.

The medical assistant’s job description includes measuring a patient’s vital signs, such as blood pressure, weight, height, heart rate, respiratory rate, temperature, and saturation. The medical assistant must document the patient’s vital signs and report any abnormal signs to the nursing practitioner. The medical assistant recorded low blood pressure but did not inform the nurse practitioner of this abnormal result. The lack of reporting is against the medical assistant’s safety practice toward a patient. If the nurse practitioner did not look at the patient’s medical chart, the patient’s therapy would not have considered the low blood pressure. Hypotension is a condition that requires medical attention (Sharma et al., 2022). The medical assistant committed an ethical and legal violation by not reporting the low blood pressure to the nurse practitioner. The medical assistant was caught up in an argument, which made her forget to report to the nurse practitioner. She was arguing with other staff members, violating work ethics and practice. Nonetheless, the medical assistant must conduct her duties toward patients without distractions such as arguments. In this case, the medical assistant focused on arguing with another staff member instead of caring for the patient.

Nurse practitioners work with other staff members, such as medical assistants, to ensure patient recovery and safety. Nurse practitioners receive reports on a patient’s vital signs, especially abnormal ones, from a medical assistant. Information received from the medical assistant is used to curate or adjust a patient’s care plan. Nurse practitioners are legally responsible for ensuring patients are appropriately managed according to their signs, symptoms, evaluation, history, and diagnosis. Nurse practitioners are legally held responsible for any patient mismanagement. If the nurse practitioner had not looked at the patient’s chart, she would not have been aware of the patient’s low blood pressure and would have, therefore, not considered hypotension when managing the patient. The patient would have been legally right to sue the nurse practitioner for mismanagement (Olejarczyk & Young, 2022).

A medical director is responsible for hiring staff members in a hospital. The hospital medical director hired staff such as the medical assistant 15 years ago when the hospital was opened and the nurse practitioner less than three months ago. The medical director must ensure that every staff member understands their job description and legal and ethical requirements. The medical director should report and resolve conflicts and arguments between staff members. The conflict between the medical assistant and other staff members has led to arguments that have ended with the medical assistant neglecting her duties. A medical director handles any lawsuits of patient negligence or mismanagement.

Strategies to Prevent Further Dangerous Patient Outcomes

Healthcare team members must be trained on the advantages of teamwork toward positive patient outcomes. Accordingly, the medical director should inform staff members of available conflict resolution channels at the hospital. Another strategy is continuous medical education. Continuous medical education must include ethical and legal responsibilities for healthcare practitioners. In addition, hospital policies should include penalties for misconduct. Essentially, staff members must understand how patient negligence can affect their licensing and practice and the hospital’s practice.

Leadership Qualities to Effect Positive Change

The hospital’s leadership should practice fairness without discrimination and preferential treatment (Bayot & Varacallo, 2022). The medical director should handle every conflict and disagreement among staff members without giving preferential treatment to those who have worked at the hospital longer or based on the cadre. Also, the medical director should be readily available to listen to staff members’ complaints and reports.

References

Bayot, M. L., & Varacallo, M. (2022). Management Skills. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544227/.

Olejarczyk, J. P., & Young, M. (2022). Patient Rights and Ethics. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/.

Sharma, S., Hashmi, M. F., & Bhattacharya, P. T. (2022). Hypotension. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499961/.

Young, M., & Wagner, A. (2022). Medical Ethics. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK535361/.

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Purpose
Discuss potential complications in a clinical scenario at an outpatient family practice. Students will explore potential effects on patient outcomes and implications for healthcare team members due to conflict among the healthcare team. Students will develop strategies that prevent untoward outcomes that result in a positive practice culture.

Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:

Recognize potential areas of conflict in NP clinical practice (CO1)
Determine methods of data collection to assess the conflict (CO3)
Examine corporate compliance and its effect on clinical practice (CO2)
Understand risk management in clinical practice (CO4)

Requirements:
You are a family nurse practitioner in a large hospital’s outpatient primary care office. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than three months. In that short time, you have witnessed several clinical staff engaging in heated arguments with each other, sometimes in inpatient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she would report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, impede patient flow through the office, and impact patient safety.

Case Study Responses:
Analyze the case study for potential issues for healthcare team members from office conflict. Contrast the potential effects for each healthcare team member based on the week’s required readings. Discuss the potential ethical and legal implications for each of the following practice members:
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?
What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.