NR506NP: Organizational Change and Ethical-Legal Influences inAdvanced Practice Nursing CaseStudyWeek 2: Organizational Change and Ethical-Legal Influences in Advanced Practice NursingCase Study (Orig Post due Wednesday, Responses due Sunday) (2020)Week two DiscussionQuestionsWhat are the potential ethical and legal implications for the Medical Assistant, NursePractitioner, Physician, and the practice?Medical assistants (MAs) perform basic tasks such as administrative, clinical, and clerical dutiesdelegated by the providers in the practice once they have adequate training (Balasa, n.d.). Texasdoes not have a scope of practice for MAs because they are not licensed, instead there are rulesfor physician delegation (Texas Occupations Code, Title 3, 2003). Medical assistants are notlicensed professionals and physicians cannot delegate tasks that require a license to practice,which means Stephanie may not prescribe medications independently, and may not triage apatient because it requires clinical judgement (Balasa, n.d.).In this scenario, the MA is practicing medicine without a license and putting the patient, thepractice, the physician, and the NP at risk by ordering a medication and fraudulently assigningthe nurse practitioner’s name to the order. The MA’s action is unethical, illegal, andunacceptable. The expectation for any healthcare professional is that they know their scope ofpractice and with Stephanie’s tenure, it is hard to believe she does know the boundaries.The MA’s decision to prescribe a medication without discussing the patient’s call and complaintswith the physician or nurse practitioner creates not only a potentially harmful situation for thepatient, but sets up the nurse practitioner, physician, and the practice for legal consequences ifharm comes to the patient. In addition to the liability and legal concerns, this act would create atrust issue within the practice. Not only do physicians and NPs have the legal consequences tocontend with, they may also have disciplinary action taken against their license if foundnegligent. Because the lawsuit malpractice risk is high in primary care offices, there must bestrict protocols, thorough training, and supervision of non-licensed staff for patient and practicesafety (Page, 2018). Page (2018) discusses the malpractice/liability coverage often requireswritten protocols to be in place for non-licensed staff to follow, and if violated they may notcover the physician, NP, or the practice.
