Ethical and Legal Implications

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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 the 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:
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:
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?
What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.

Sample Solution

Selective Serotonin Reuptake Inhibitors, or SSRIs. They are the most popular because they are very effective and have fewer side effects than other antidepressants. The main purpose of antidepressants is to improve the way the brain uses certain chemicals that control mood or stress. It is common for depressed patients to test out different antidepressant medication before finding the one that works best for them. The best way to know when you found the right medication is when there are noticeable improvements in your symptoms and has manageable side effects. Antidepressants often take 2 to 4 weeks to work. Before you notice a mood change, symptoms such as sleep, appetite, and concentration issues improve so it is important to give a medication a chance before concluding it does not work for you. The most important part about treating depression with antidepressants is to not stop taking them without consulting a doctor first. For some people, if they decide to stop taking the medication their depression returns and worsens. A doctor will slowly decrease the dosage over the course of 6 to 12 months because stopping them abruptly will cause the body to experience withdrawal symptoms. Despite there being several positives that come out of taking antidepressants there has been one potential downside. There have been cases of patients under the age of 25 who have experiences an increase of suicidal thoughts and behaviors while taking antidepressants. These situations are not very common but is a risk that people suffering from depression should take into account when considering antidepressants as their treatment method. This is a warning from the U.S. Food and Drug Administration, or FDA, that states every patient regardless of their age should be closely monitored during the first few weeks of treatment. Psychotherapy is another method that can offer useful treatment for depression. Psychotherapy, also referred to as talk therapy, is another very common method especially when combined with antidepressant therapy. There are several types of psychotherapy, examples include Cognitive-Behavioral therapy (CBT), Interpersonal therapy (IPT), and Problem-Solving therapy. Psychological therapy helps regulate moods and with effective treatment, it can stimulate new nerve cell growth to assist in regulating moods. If antidepressants or psychotherapy do not reduce depression symptoms, Electroconvulsive therapy (ECT) or other stimulation of the brain therapies are options one should explore. ECT provides relief to people suffering from severe depression who were not successfully treated b

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