Advanced Practice Nursing: Ethics, Law and Organizational Change

This assignment analyzes a case study involving a primary care office and explores the ethical and legal implications of actions taken by medical staff, particularly a medical assistant and nurse practitioner. The discussion addresses potential negligence, violations of ethical imperatives, and the impact on patient outcomes. The student identifies immediate actions needed to address patient concerns and strategies to prevent future issues, emphasizing the importance of comprehensive patient consultations and follow-up procedures. The assignment also examines leadership qualities, such as emotional intelligence, effective communication, and mentorship, required to foster positive organizational change and improve the practice's culture through continuous learning and skill enhancement. The student references relevant literature to support their analysis.

Running head: ORGANIZATIONAL CHANGE AND ETHICAL-LEGAL INFLUENCE
ORGANIZATIONAL CHANGE AND ETHICAL-LEGAL INFLUENCE
Name of the Student:
Name of the University:
Author’s Note:

2ORGANIZATIONAL CHANGE AND ETHICAL-LEGAL INFLUENCE
Answer 1
From the case study, it can be seen that there are potential ethical and legal
implications for the medical team working in the primary care office. The medical assistant is
stated to be a qualified professional that helps the doctor with administrative and treatment-
related procedures; however; it may vary from time-to-time. The legal implication that
Stephanie, as well as another medical assistants, involves questioning upon their medical and
pharmacological training as well as involve a case of the tort of negligence as the patient, Mrs
Smith had called Stephanie and told her about her cough however, the matter remained
unresolved for a week (Buppert, 2017). The nurse practitioner is a registered nurse
responsible for taking care of the patient’s need, order and diagnostic duties. Mrs Smith was a
patient of the registered nurse as the medicine bottle specify the name; thus, the ethical and
legal imperatives have been ignored that might result in long-term impact on the patient
similar to a clinical case in Children's Medical Center of Tehran University of Medical
Science (Kadivar et al., 2017). It may lead to a serious legal impact on the multidisciplinary
team of the primary care office. The legal implication will be maximum for the Medical
Director as the person owns the care unit and is thus, responsible for all the legal and ethical
aspects. The practice of negligence on behalf of the entire medical team was stated to be
ethically and legally inaccurate and inappropriate and is deemed to attract criticism.
Answer 2
The immediate action that needs to be taken was to address the patient’s reason for
visiting the care centre. As per the opinion of DeNisco & Barker (2015), the duty of
conducting a comprehensive patient consultation or interview before prescribing the
medications is critical. Even though, Stephanie’s intention was good; however, there is an
ethical issue related to it. If the dose of amoxicillin was not able to clear the cough, the nurse

3ORGANIZATIONAL CHANGE AND ETHICAL-LEGAL INFLUENCE
need not refill the bottle; instead, re-examination needs to be done. In addition to this, the
strategy that can be taken to avoid further issues of such illegal behaviour was to routinely
follow-up with the medical assistants about the detail of the patient or calls related to patients.
Answer 3
Rodney & Varcoe (2016) opined that nursing practice includes a range of activities,
duties, responsibilities that the nurse is authorised to perform by maintaining standards. The
multifactorial aspect of the practice makes it challenging to work in a stressful environment.
With respect to the given case study, the leadership qualities that need to be applied to have a
positive change in the practice, as well as the culture of the organisation, are emotional
intelligence that involves working with the other staffs, dedication to excellence, effective
communication skills, integrity and mentorship. Even though it can be seen that some staffs
have experience; however, initiating continuous learning and improvement environment in
the primary care office will help in diligently working, enhancing the skills and knowledge
over the time.

4ORGANIZATIONAL CHANGE AND ETHICAL-LEGAL INFLUENCE
References
Buppert, C. (2017). Nurse practitioner's business practice and legal guide. Jones & Bartlett
Learning.
DeNisco, S. M., & Barker, A. M. (Eds.). (2015). Advanced practice nursing: Essential
knowledge for the profession. Jones & Bartlett Publishers.
Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017).
Ethical and legal aspects of patient’s safety: a clinical case report. Journal of Medical
Ethics and History of Medicine, 10.
Rodney, P., & Varcoe, C. (2016). Towards ethical inquiry in the economic evaluation of
nursing practice. Canadian Journal of Nursing Research Archive, 33(1).