NR 506 Week 5 Ethical and Legal Implications

Student Name

Chamberlain University

NR-506: Healthcare Policy

Prof. Name:

Date

Decision Making in Nursing Practice: A Concept Analysis

Ethical and Legal Implications

As a Family Nurse Practitioner (FNP) working in an outpatient primary care office within a large hospital system, you encounter a situation that highlights the ethical and legal challenges of working in a healthcare setting. The practice has been operating for over 15 years, with many of the clinical and administrative staff having been employed since its inception. However, having been with the practice for less than three months, you observe several instances of staff members engaging in heated arguments, sometimes even in patient areas. During one particular instance, you overhear an argument between two staff members and notice that the Medical Assistant (MA) has failed to report a patient’s dangerously low blood pressure. When questioned, the MA explains that she was going to notify you about the vital signs but got distracted by the argument. Unfortunately, this behavior seems to be a recurring issue in the practice, where conflict among staff impedes patient care and could potentially harm patients. In a clinical setting, it is critical that staff cooperate effectively, as dysfunction can hinder the delivery of care, impede patient flow, and negatively affect patient safety.

Potential Ethical and Legal Implications for Healthcare Team Members

The unresolved conflict within the practice presents ethical and legal challenges for several healthcare team members.

Medical Assistant (MA): The MA’s failure to notify the Nurse Practitioner (NP) about the patient’s low blood pressure violated the ethical principle of beneficence, which emphasizes the duty to do good and ensure the well-being of others. By allowing a conflict to interfere with her responsibilities, the MA potentially jeopardized patient safety and exposed the practice to legal risks, including malpractice or negligence, depending on the patient’s outcome.
Nurse Practitioner (NP): Although the NP did not fail to report the vital signs directly, they still bear ultimate responsibility for patient care. In this scenario, the NP could face ethical and legal implications due to the ongoing conflict among staff members. Failure to address this behavior could lead to legal action against the NP for malpractice or negligence, as it reflects a lack of oversight in managing the practice’s environment, which could negatively affect patient outcomes.
Medical Director: The Medical Director holds overall ethical and legal responsibility for both the staff and patient care in the practice. By allowing conflicts to persist, the Medical Director fails to uphold the ethical principles of nonmaleficence, beneficence, and justice. The persistent conflict among staff has undermined patient care, making the practice vulnerable to lawsuits due to negligence or malpractice.
Practice: A collaborative team approach is essential for effective healthcare delivery. The lack of teamwork and cooperation within the practice undermines patient safety and care. If the issue of conflict is not addressed, the practice could face malpractice lawsuits and allegations of negligence, particularly concerning delayed diagnoses or treatment.

Strategies for Preventing Dangerous Patient Outcomes

To prevent further episodes of unprofessional behavior and potentially dangerous patient outcomes, several strategies should be implemented.

Identify the Causes of Conflict: The first step in addressing the issue is to identify the root causes of the conflicts among staff members. Understanding the underlying issues will help in developing appropriate solutions to improve team dynamics and patient care.
Promote Effective Communication: Clinical staff should be educated on the importance of effective communication. Heated arguments, especially in patient areas, should not be tolerated. Encouraging respectful and professional communication will help mitigate conflicts and improve team interactions. It is also important to recognize and address barriers to communication.
Promote Teamwork: Every staff member must be treated with respect and as an integral part of the team. Effective teamwork has been shown to enhance the quality of care, improve patient safety, reduce staff stress, and increase job satisfaction. By fostering a team-oriented environment, the practice can improve both staff morale and patient outcomes.
Teach Conflict Resolution Skills: Staff should be trained in conflict resolution strategies. It is important to address conflicts promptly to prevent escalation. Effective conflict resolution can help build trust among team members, enhance communication, and prevent hostility within the workplace.

Leadership Qualities for Positive Change

To foster a culture of collaboration and improve the overall functioning of the practice, leadership plays a pivotal role. As a transformational leader, you can effect positive change by building trust, promoting open communication, and inspiring others to engage in the process of change. A strong leader influences others’ beliefs, values, and behaviors, motivating them to work together towards common goals. Transformational leadership has been shown to be effective in improving organizational culture and patient care outcomes.

Table: Ethical and Legal Implications of Conflict in Healthcare Practice

Healthcare Team Member	Ethical Implications	Legal Implications
Medical Assistant (MA)	Violated beneficence by neglecting patient safety due to conflict.	Exposed practice to malpractice or negligence claims depending on patient outcomes.
Nurse Practitioner (NP)	Failed to address staff conflict, compromising beneficence and oversight.	Risk of legal action for malpractice due to failure in managing patient safety and staff behavior.
Medical Director	Violated nonmaleficence, beneficence, and justice by allowing conflict to persist.	Potential for lawsuits related to negligence or malpractice.
Practice	Lack of teamwork undermines patient safety and ethical practice.	Could be held liable for malpractice and negligence due to unresolved conflicts and delayed care.

References

Agency for Healthcare Research and Quality. (2019). Section 4. Identifying Strategies. Retrieved from https://www.ahrq.gov/research/findings/final-report/ptflow/section4.html

Atkinson, P., & Mackenzie, R. (2015). Without leadership there is no change.

Fischer, S. (2016). Transformational leadership in nursing: A concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653. doi:10.1111/jan.13049

Ganta, V. C., & Manukonda, J. K. (2014). Leadership during change and uncertainty in organizations. International Journal of Organizational Behavior & Management Perspectives, 3(3), 1183.