...Jerry McCall Ethics Case Study Overview This is an USA pseudo-case diverged from the following Medical and Ethics Textbook case study in Ch. 4 of Medical Law and Ethics that gives insight to medical – ethics and their applications (Fremgen, 2010, p. 85). Jerry McCall is Dr. Williams’s office assistant. He has received professional training as both a medical assistant and an LPN. He is handling all the phone calls while the receptionist is at lunch. A patient calls and says he must have a prescription refill for Valium and that the provider, a friend, calls in the medication prior to any flights. This type of request happens often and in slightly different scenarios, but the outcome should remain the same to avoid ethical and legal issues. This paper will review the case study to help resolve the problem, the ethics involved, and the medical responsibility to refilling a prescription without provider authorization. Qualified Medical Training Understanding the definitions of a licensed practical nurse, LPN, and a medical assistant, MA is the first step to making a factual conclusion for this case study. Support staff to the provider cannot make decisions about medication refills for patients without a direct order from the provider. This action is outside the scope of practice for an LPN or MA. Licensed Practical Nurse An LPN is a role in support of the nurse or RN, a registered Nurse usually in a skilled nursing setting such as a hospital or long-term care facility...
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...Sawyer AUI Credentialing for physicians and nurses and other non medical providers Physicians Credentials The role of a physician is to diagnose and treat the illnesses of their patients. When a physician sees a patient who has an injury or is ill, the physician must first identify the problem or diagnosis the illness. A physician’s credential is a personal qualification of achievement and trustworthiness that can be used to substantiate and verify competence and licensure. These documents represent evidence of a provider’s training, licensure, expertise and experience. Why credential providers? • To protect patients. • To verify that doctors meet accreditation and state licensing standards. • To verify that doctors are who they represent themselves to be. • To confirm clinical competence. Non-Physician Credentials by state law, must complete an accredited, formal education program. The majority holds a bachelor’s degree. Although they are employable with an Associates. Are licensure requirements different form state to state In each state, the State Board of Nursing specifies what educational, clinical, and licensure requirements are necessary to practice in the state. Nurse Practice Act (state legislation that sets out the requirements for nurse licensure in the state) contains the states requirements for the practice. All 50 states require that nurses remain licensed in order to practice and it varies from state to state. (Austin &...
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...Ethical Case Study- Jerry McCall HCS/335 Ethical Case Study: Jerry McCall Jerry McCall is a Medical Assistant for Dr. Williams. One afternoon Jerry was covering the front office while the receptionist was out to lunch. He received a phone call from a patient who requested a refill for Valium. The patient had stated that he and Dr. Williams are personal friends and Dr. Williams always gives him “a small supply of Valium before he leaves on a trip” (Fremgen, 2009 p. 85). Jerry was the only person in the office at the time of the phone call. Should Jerry refill the medication? No Jerry should not and I will explain why this is not ethically right. Valium also known as Diazepam is a “benzodiazepine, it affects chemicals in the brain that may become unbalanced and cause anxiety” (drugs.com, 2013) Benzodiazepine is drugs that, “affect gamma-aminobutyric acid (GABA), a neurotransmitter chemical that nerves use to communicate with one another” (rxlist.com, 2013). Valium is used to treat anxiety, seizures, insomnia, and at times light sedation for medical procedures. Jerry works for Dr. Williams as a Certified Medical Assistant (CMA) not a Licensed Practical Nurse so he must follow the Certified Medical Assistant Scope of Practice. In the State of California “Medical assistants are unlicensed individuals who perform non-invasive routine technical support services under the supervision of a licensed physician and surgeon or podiatrist in a medical office or clinic setting. The...
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...My Nursing Practice Analysis Nursing has been a significant part of my life for more than 31 years. During my career, I have taken care of thousands of patients, and knowing that I have been a part of a patient’s healing process and grieving process is satisfying. The American Nurses Association (ANA) (2010) states, “The art of nursing is based on caring and respect for human dignity” (p. 23). As a nurse, respecting my patient’s dignity is part of my role. I am upholding the ethical values set by the ANA by respecting the dignity of my patients with respect to his or her medical and personal decisions concerning treatment. ANA (2010) provision seven states, “The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development” (Fowler, p. 143). I have an obligation as a nurse to be actively involved in health policy and with organizations that engage in community activities such as volunteering for free health clinics and free medical care for the underprivileged. I have an obligation as a nurse to become a mentor in my community. I would like to educate my community on the importance and ramifications of unhealthy eating and its effect on a person’s health. I would also attend state and budgetary meetings and provide testimony on the benefits of healthy eating and the health care problems that unhealthy eaters face, and assist those who do not have the funds to eat healthy. According to ANA (2010)...
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...Ethics Case Study Brenda Gary HCS/335 Ethics: Health Care and Social Responsibility February 21, 2012 Ken Parker Ethics Case Study The health care system of today is different from that of the past. Incidents of patient injuries that would have gone ignored by the family or patient in the past are now the basis for malpractice lawsuits. The issue today for most health care facilities is liability. The law on torte and negligence (2012) sees liability as a major risk not only for the physician but also for allied healthcare professionals working under the direct supervision of a medical supervisor, such as a medical assistant. When a medical assistant takes it upon himself to perform tasks outside the scope of his training or skills, the physician may be liable for any injuries or damages caused by the employee. Jerry McCall In this scenario, Jerry McCall, is an office assistant who has training as a medical assistant and Licensed Practical Nurse. He receives a phone call from a patient requesting a Valium refill before a plane ride. The patient stresses that he is leaving for the airport within thirty minutes and that Dr. Williams (whom Jerry work for) is a friend who gives him a small supply of the antidepressant Valium when he has to fly. Jerry is the only person in the office at the time of the call and has to decide what to do. Though Jerry may want to help the patient, he cannot. Jerry is a trained professional but he does not have the authority to...
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...Health Services Research r Health Research and Educational Trust DOI: 10.1111/j.1475-6773.2011.01274.x RESEARCH ARTICLE Staffing Ratios and Quality: An Analysis of Minimum Direct Care Staffing Requirements for Nursing Homes John R. Bowblis Objective. To study the impact of minimum direct care staffing (MDCS) requirements on nurse staffing levels, nurse skill mix, and quality. Data Sources. U.S. nursing home facility data from the Online Survey Certification and Reporting (OSCAR) System merged with MDCS requirements. Study Design. Facility-level outcomes of nurse staffing levels, nurse skill mix, and quality measures are regressed on the level of nurse staffing required by MDCS requirements in the prior year and other controls using fixed effect panel regression. Quality measures are care practices, resident outcomes, and regulatory deficiencies. Data Extraction Method. Analysis used all OSCAR surveys from 1999 to 2004, resulting in 17,552 unique facilities with a total of 94,371 survey observations. Principle Findings. The effect of MDCS requirements varied with reliance of the nursing home on Medicaid. Higher MDCS requirements increase nurse staffing levels, while their effect on nurse skill mix depends on the reliance of the nursing home on Medicaid. MDCS have mixed effects on care practices but are generally associated with improved resident outcomes and meeting regulatory standards. Conclusions. MDCS requirements change staffing levels and skill mix, improve certain aspects of...
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...or technology degree program within the last five years, please contact your Academic Advising Office as you may not be required to submit an application. If you are a graduate of a business, health sciences, liberal arts, technology, or nursing degree program, please contact your Academic Advising Office as you may not be required to submit an application. Licensed practical/vocational nurse Licensed massage therapist Certified pharmacy technician School of Nursing Candidates In addition to official transcripts, nursing candidates must submit a copy of a current license or certification to verify professional status in an appropriate health care profession. This license should be mailed with your application or faxed to the Undergraduate Application for Admission Team at 518-464-8833. Bachelor of Science in nursing (BRN) and RN to Master of Science in nursing (MRN) applicants must submit an official transcript showing the completion of associate degree nursing education or RN diploma education. Nursing courses completed at institutions other than Excelsior College are only evaluated upon enrollment. International Nurses: Admission to the associate degree in nursing programs is not open to international students. See page 6 for additional information. Required Documents You are required to submit official copies of transcripts as part of the application process. Official transcripts/documents are those that a college, testing agency, or education office sends or gives to...
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...maintaining the health status. Nurses are a major workforce in the provision of health care. Where does this discussion lead? Is there a serious threat? What happens now? Is it global? All these questions pump adrenaline to everyone who is concern about their health status. Health care organizations, specifically hospitals have significantly felt the impact of nursing shortage. Nurses are an integral part of any health care organization; and are known to the health care community as front line workers. The following outline is to discuss a health care situation such as nursing shortage in hospital settings. This outline is to provide a comprehensive overview by analyzing and evaluating the effectiveness of procedures that are in place, and recommend improvement strategies based on economic theories and concepts that support best practices. Key Players Nursing shortage is a work in itself, there is no immediate solution to the problem; therefore, nurses as the key players must be involved in the decision making occurring at every health care organization. As nurses, the sole responsibility lies upon them to establish a safe working environment, ensuring patients and nurses’ right be upheld at all times, and nurses upholding the highest quality of care rendered to patients. Nurses must be intensely involved in committees to have a voice and in-puts and must be willing to effect change. Therefore, we must look at the accrediting body for nursing organizations, nurses who work in hospital...
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...sentinel event of Mr. B, a sixty-seven-year-old patient presenting with severe left leg pain at the emergency room. A root cause analysis is necessary to investigate the causative factors that led to the sentinel event. The errors or hazards in care in the Mr. B scenario will be identified. Change theory will be utilized to develop an appropriate improvement plan to decrease the likelihood of a reoccurrence of the outcome of the Mr. B scenario. A Failure Modes and Effects Analysis (FMEA) will be used to project the likelihood that the suggested improvement plan would not fail. Lastly, key roles nurses would play in improving the quality of care in the Mr. B scenario will be discussed. A. Root Cause Analysis A root cause analysis (RCA) is “a process for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event” (Cherry & Jacob, 2011, p. 442). The participants during the root cause analysis would be the emergency room physician (Dr. T.), the Mr. B’s LPN and RN (Nurse J) during the time of the sentinel event, the emergency room nurse manager, and the chief nursing officer (CNO) of the hospital. These members would meet in a root cause analysis meeting to discuss the causative factors that created Mr. B’s sentinel event. The first step in a root cause analysis on the sentinel event that caused Mr. B’s death is to gather the data surrounding the situation. Mr. B’s vital signs, including...
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...Ethics Interview on Registered Nurse. Name: ---------------. Institution: ----------------. Course: Law & Ethics. Prof. Agapito Sta. Romana. ETHICS INTERVIEW ON REGISTERED NURSE Abstract Registered nurses are normally the clinicians who are expected to have taken their studies up to at least an associate degree in nursing. These practitioners are usually trained for about two years in such areas as medications, anatomy, and physiology as well as practical patient care. These professionals are also expected to pass the board exam that qualifies them to be accepted in their particular nations that they belong as well as the whole world at large. Moreover, they are also required to have a license from the board that governs their profession. (American Nurses Association, 2010) The registered nurses usually work under the supervision of the qualified physicians in the hospitals and are also assisted by the nurse assistants in those particular clinics. Nurse assistants are often considered of lower medical qualifications as compared to the registered nurses in the hospitals. According to my knowledge before the interview, a registered nurse profession gives them the ability to be mandated to supervise licensed practical nurses, assisting nurses, as well as the orderlies in any given clinic or hospital. (Clark, Cowan & Wortley, 2009) Moreover, I believed that according to the medical knowledge that registered nurses possess they are supposed to be in...
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...Competency: Analysis of the Concept Michelle Trigg University of South Alabama Abstract Understanding the nature and meaning of nursing competency is the initial step in having an unambiguous definition of its practice. All healthcare professionals, including nurses, may only prove to be proficient in their capabilities if they are able to perform comprehensive assessments related to the provision and maintenance of safe and efficient care, the protection of all members of the general public, and the undertaking of all necessary actions in order to preserve the nursing profession. Any and all standards that are established, based on such a perspective, must be adhered to in practice and for the purpose of nursing evaluation. This paper will evaluate and explore the concept of competency and the ways in which the nursing profession integrates the many aspects of competency. Keywords: competence, competency, concept analysis Competency: Analysis of the Concept The concept of competency in nursing is a professional regulation and is extremely important to patient safety and outcomes. In the past, competency in nursing focused on evaluating clinical skills, and not the actual ability(ies) or comprehension of the science behind them (Allen et al., 2008). Nurse competency is a requirement in the clinical setting, and outlines the dimensions...
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... This paper will analyze the cause of the sentinel event which occurred to Mr. B, a sixty seven year old patient which presented to the emergency room with left leg pain. A root cause analysis will be necessary in this case to investigate the causative factors which led to Mr. B’s sentinel event. The factors in this unfortunate case weather they were errors in his care, or hazards in the system will be identified. The Change theory will be used to develop an improvement plan that will be used to decrease the chances of a reoccurrence of the sentinel event that happened to Mr. B. in the scenario. Root Cause Analysis A root cause analysis, is a system that is used to develop a plan that will identifying the causative factors of an adverse event and formulate a plan to decrease the occurrence or chances of a sentinel event. A team consisting of , a member of the hospital administration, a pharmacist, a respiratory therapist, a charge nurse or nurse manager, a physician, and a member of the family board should be brought together to perform a root cause analysis in this case. These team members would have a meeting to discuss the factors that led to Mr. B’s sentinel event. The first step would be for the team to begin interviewing the staff involved with the case to gather as much data as possible. The data that would be needed include, Mr. B’s vital signs, laboratory results, pain scores, a history of medication that he was given during his time in the emergency...
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...Ethics Case Study Stacey HCS/335 September 22, 2011 Dr. Lawrence Fergus Ethics Case Study The purpose of this paper is to discuss a hypothetical case analysis involving Dr. Williams’ office assistant Jerry McCall. Jerry was in the office answering phones while the receptionist was at lunch when he received a call from a patient who stated he had an urgent need for a prescription called into the pharmacy. The patient was leaving town within minutes and needed the medication prior to catching his flight. The paper will discuss Jerry’s qualifications to write prescription medications. The doctrine of respondeat superior and how it applies to Jerry in this situation is discussed. Problem-solving methods and major legal and ethical issues that would be helpful in Jerry’s decision making are also conferred. Scope of Practice Jerry McCall is Dr. Williams’ office assistant. He is received training as both a Licensed Practical Nurse (LPN) and a Medical Assistant (MA). However, according to the scope of practice of both an LPN and MA, neither is permitted to write prescriptions and call them into the pharmacy (Fremgen, B., 2009). An MA’s scope of practice does not allow for them to write, refill, or call in prescription medications under any circumstances. This practice does not fall within their scope of practice and doing so would be unethical and illegal. Writing prescriptions is not in the scope of practice of an LPN and therefore Jerry should not write this prescription...
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...NCLEX-RN® DETAILED TEST PLAN 2010 NCLEX-RN Detailed Test Plan ® Effective | April 2010 Item Writer/Item Reviewer/Nurse Educator Version Mission Statement The National Council of State Boards of Nursing, composed of member boards, provides leadership to advance regulatory excellence for public protection. Purpose and Functions The purpose of the National Council of State Boards of Nursing (NCSBN ) is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. ® The major functions of NCSBN include developing the NCLEX-RN and NCLEX-PN examinations, performing policy analysis and promoting uniformity in relationship to the regulation of nursing practice, disseminating data related to NCSBN’s purpose and serving as a forum for information exchange for NCSBN members. ® ® Copyright© 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. NCSBN , NCLEX , NCLEX-RN and NCLEX-PN are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN. ® ® ® ® Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document...
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...parts of a nursing diagnostic statement. Describe the rationale for setting priorities. Discuss appropriate circumstances for short-term and long-term goals. Identify four ways to document a plan of care. Describe the information that is documented in reference to the plan of care. Discuss three outcomes that result from evaluation. n the distant past, nursing practice consisted of actions based mostly on common sense and the examples set by older, more experienced nurses. The actual care of clients tended to be limited to the physician’s medical orders. Although nurses today continue to work interdependently with physicians and other health care practitioners, they now plan and implement client care more independently. In even stronger terms, nurses are held responsible and accountable for providing client care that is appropriate and reflects currently accepted standards for nursing practice. I problems of clients (Fig. 2-1). It is the accepted standard for clinical practice established by the American Nurses Association (ANA) (Box...
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