WEEK 2: Organizational Change and Ethical-Legal Influences in Advanced
Practice Nursing Case Study
You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one
physician and three nurse practitioners. The back-office staff includes eight medical assistants who assist with
patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription
renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10
years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport
with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same
reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a
refill. You noted the patient's name on the label, and the date on the bottle was 1 week ago. You also noted your
name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough
and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in
the practice.
Case Study Questions:
1.What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
2.What strategies would you implement to prevent further episodes of potentially illegal behavior?
3.What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the
culture of the practice
Hello Class and Professor Lilly,
According to the American Association of Medical Assistants (2020), in the state of
Maryland, Medical Assistants (MA) are individuals who are delegated technical acts
from a physician or nurse practitioner. Medical Assistants are not certified by the state
Practice Nursing Case Study
You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one
physician and three nurse practitioners. The back-office staff includes eight medical assistants who assist with
patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription
renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10
years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport
with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same
reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a
refill. You noted the patient's name on the label, and the date on the bottle was 1 week ago. You also noted your
name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough
and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in
the practice.
Case Study Questions:
1.What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
2.What strategies would you implement to prevent further episodes of potentially illegal behavior?
3.What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the
culture of the practice
Hello Class and Professor Lilly,
According to the American Association of Medical Assistants (2020), in the state of
Maryland, Medical Assistants (MA) are individuals who are delegated technical acts
from a physician or nurse practitioner. Medical Assistants are not certified by the state
