NR 506 Week 2 Case Study

Student Name

Chamberlain University

NR-506: Healthcare Policy

Prof. Name:

Date

Ethical and Legal Implications in Advanced Practice Nursing

In the case study presented, ethical and legal implications arise for all members of the interdisciplinary healthcare team. The medical assistant, Stephanie, violated ethical principles, particularly nonmaleficence, which requires healthcare providers to do no harm. Her decision to prescribe amoxicillin without the necessary medical qualifications placed the patient at risk for adverse reactions, including allergic responses and incorrect dosing. Legally, medical assistants must operate under the supervision of a nurse practitioner (NP) or a physician, as determined by state regulations. Stephanie’s actions—falsifying a nurse practitioner’s identity, forging a prescription, and misusing prescriptive authority—constitute serious legal violations. Consequences may include the suspension or revocation of her certification, monetary fines, imprisonment, and restrictions on future employment in other states (Office of Professional Licensure and Certification, 2017).

The nurse practitioner (NP) in this scenario also bears ethical and legal responsibility for malpractice due to a failure to uphold justice, ensuring fair and equal treatment for all patients. The NP failed to adequately supervise Stephanie, leading to unauthorized medical actions. Legally, this lack of oversight constitutes negligent supervision, making the NP liable for failing to verify prescription renewal requests, which could have prevented the medical assistant’s misconduct (Office of Professional Licensure and Certification, 2017).

Additionally, the medical director, responsible for overseeing the practice, is implicated both ethically and legally. Ethically, the director failed to ensure proper employee training and screening, which contributed to the incident. Legally, the director is held accountable under the respondeat superior doctrine, which states that an employer is responsible for employees’ actions within the scope of their employment. Consequences for the practice could include legal fines and lawsuits (Cornell Law School: Legal Information Institute, 2020).

Strategies to Prevent Further Illegal Behavior

To mitigate future instances of illegal behavior, several strategies must be implemented. Education and training on state scope of practice laws should be reinforced among all staff members. Training topics should include licensing requirements, professional responsibilities, liability risks, and prohibited actions. Routine credentialing and background checks should be mandated for all employees to verify qualifications and maintain professional integrity.

Furthermore, the establishment of clear policies and protocols can provide a structured framework for interdisciplinary teams, reducing the likelihood of unauthorized actions. Contracts outlining role responsibilities and expectations should be enforced. Despite these measures, human error remains possible; therefore, encouraging malpractice liability insurance for all practitioners offers additional legal protection (Emergency Care Research Institute, 2015).

Leadership Qualities for Positive Change

To promote a culture of ethical practice and accountability, advanced practice registered nurses (APRNs) must demonstrate strong leadership qualities. Collaboration and coaching are essential for fostering teamwork and ensuring that all healthcare providers understand their roles and responsibilities. Effective collaboration enhances trust in the NP’s leadership and promotes adherence to practice guidelines.

Moreover, an evidence-based approach should be applied, integrating research and policy knowledge into practice. NPs should use their expertise in ethical decision-making and consultation to guide interdisciplinary teams toward best practices (Heinen et al., 2019). By fostering an environment of continuous learning and professional development, APRNs can enhance patient safety and prevent future ethical and legal violations.

Table Format

Category	Ethical and Legal Implications	Strategies for Prevention	Leadership Qualities for Positive Change
Medical Assistant	Violated nonmaleficence by prescribing medication without proper qualifications. Engaged in illegal acts such as falsifying identity and misusing prescriptive authority. Potential penalties include loss of certification, fines, and legal consequences.	Reinforce training on scope of practice laws, implement strict supervision, and establish clear job roles.	Requires structured oversight, ensuring medical assistants understand their responsibilities.
Nurse Practitioner	Failed to uphold justice by not ensuring fair treatment of patients. Legally liable for negligent supervision.	Mandate direct supervision and verification of prescription requests. Implement routine audits.	Must exhibit collaboration, consultation, and ethical decision-making to prevent malpractice.
Medical Director	Ethically responsible for inadequate staff screening and training. Legally accountable under the respondeat superior doctrine, making the practice liable for employees’ actions.	Conduct comprehensive employee background checks, enforce strict hiring protocols, and establish training programs.	Strong leadership and policy enforcement are crucial to fostering an accountable workplace.

References

Cornell Law School: Legal Information Institute. (2020). Respondeat superior. Retrieved from https://www.law.cornell.edu/wex/respondeat_superior

Emergency Care Research Institute. (2015). Scope of practice laws for nurse practitioners and physician assistants. Retrieved from https://www.ecri.org/components/PPRM/Pages/LB5.aspx?tab=2

Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378–2392. https://doi.org/10.1111/jan.14092