NR 506 Week 5 Discussion, Healthcare Systems

You are a family nurse practitioner working in an outpatient primary care office of a large

hospital system. 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 practice

for less than 3 months. In that short amount of time, you have witnessed several of the clinical

staff engaging in heated arguments with each other, sometimes in patient 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 was going to 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,

can impede the flow of patients through the office, and could impact patient safety.

Case Study Responses:

1. Analyze the case study for potential issues for members of the healthcare team from

office conflict. Contrast the potential effects for each member of the healthcare team based

upon the required readings from the week. Discuss the potential ethical and legal implications

for each of the following practice members:

o Medical assistant

o Nurse Practitioner

o Medical Director

o Practice

2. What strategies would you implement to prevent further episodes of potentially

dangerous patient outcomes?

3. What leadership qualities would you apply to effect positive change in the

practice? Focus on the culture of the practice.

Dr. Sibel and fellow classmates,

Having staff that constantly argues and fights is unacceptable, especially when it starts to affect

patient care. In this case, the medical assistant neglected her duty of notifying me that my patient

was hypotensive. It is a major issue when patient care is compromised. Not only is the patient

affected by the argument but the medical assistant, nurse practitioner (myself), the medical

director, and the medical practice are affected. Below is a chart listing the potential ethical and

legal implications for each member of the healthcare team.

Practice Member Ethical Implications Legal Implications

Medical Assistant

(MA)

The ethical obligations of the MA

are to come to work, complete

tasks as ordered, and adhere to the

standards set forth by the

American Association of Medical

Assistants, which includes no

patient harm. While the scenario

Medical assistants have a role

to assist clinicians in practice.

It is their duty to ensure that

information gets passed on to

the provider. If the patient had

suffered harm from the MA not

informing the provider of

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