NR 582NP Week 5 Discussion; Ethical and Legal Implications in Nursing Practice

At the meso-level, this incident calls into questions if the office’s policies and procedures are being followed. It also suggests inadequate insight and communication in the workplace and legal liability for the practice and hospital system due to the MA practicing outside of her scope of practice. At the macro -level, this poses significant risks for the hospital, potentially resulting in a sentinel event or a severe medication error that could cause serious harm or even death. The fact that the medical assistant felt comfortable prescribing medication under the nurse practitioner's (NP) license adds to the legal and ethical breaches involved. This situation warrants a thorough investigation to determine if similar incidents have occurred with other patients at this practice and if any safety issues have impacted patient care. To prevent further episodes of this problem behavior, I recommend: • Clear and strict protocols regarding medication refills; • Office visit is mandatory before any prescription request; • Provide regular training sessions on ethical and legal issues in healthcare. Coaching and feedback skills that can be used to discuss the event with the MA: • Actively listening to the MA’ s perspective and motivation to the act; • Explaining the issue clearly and its potential consequences; • Reviewing the scope of practice with the MA; • Providing clear expectations for future behaviors; • Providing training to help her meet these expectations. Lewin’s Theory of Planned Change would be more beneficial for this organization. This theory focuses on preparing the organization for change (unfreeze), making the transition (implement changes), and stabilizing the new behaviors (refreeze). In this situation, Lewin’s Theory would help by identifying the problem first, implementing these recommendations and coaching skills, and then making sure it is being followed (Barrow et al., 2022). Employees often resist change, especially if they feel the change is unnecessary or they were not involved in the decision-making process. Leaders can facilitate change by setting a clear, compelling vision that justifies the need for change and aligns with organizational goals. Also, provide necessary resources and adequate training and support. Reference Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2022, September 18). Change management. In StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459 How do repeated “small” shortcuts in clinical practice evolve into normalized unsafe behaviors, and what is the NP leader’s role in interrupting that process before patient harm occurs? Thoughts? When clinical protocols are bypassed without immediate penalty, “small” shortcuts eventually morph into standard, yet hazardous, operations. result in legal consequences for both the individual and the medical practice, including malpractice lawsuits. I totally agree with you, to prevent this situation from happening again, Nurse Practitioner (NP) leaders must cultivate a "just culture" that prioritizes safety over blame. By maintaining high visibility through regular walk-rounds and focusing on patient safety. References Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer.