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Nursing Post response

One logically-sounding recourse could be to let Mrs. Smith know that after a week of taking the antibiotic Amoxicillin, she should cease taking it due to the risk of developing and amplifying antimicrobial resistance. Before authorizing a refill, the PCP must conduct a comprehensive examination of Mrs. Smith’s condition to assess the symptoms and signs and the infection prior to administering more antibiotics. As Costelloe (2010) notes, “Studies reporting the quantity of antibiotic prescribed found that longer duration and multiple courses were associated with higher rates of resistance” (p.2096). I would subsequently reevaluate the patient and possibly order further testing and blood work to further investigate her condition. After implementing a treatment modality to relieve the patient’s cough, it would be necessary to then confront Stephanie about the phone call she had with the patient by asking her what she did after speaking with Mrs. Smith who told her about the persistent cough. I would explain to her that in prescribing a refill of Amoxicillin to treat the patient’s cough, she compromised the safety of the patient because the physician did not conduct a proper examination to find out whether the cough was bacterial or viral; coughs are often viral, so administering antibiotics would be useless an could yield dire, adverse consequences for the health of the patient, including antibiotic resistance and mentioned before, and other side effects like nausea, vomiting, rashes, and diarrhea.

Another question that should be brought up is whether or not she was cognizant about her scope of practice as a medical assistant. Prior to speaking with Stephanie, I would do a little research on office policy about what happens when patients call and ask for medical advice or medication that is peripheral to the scope of practice of a medical assistant. It seems as though Stephanie, who has been working at the practice for a decade, feels comfortable with dealing with a situation that she should not without notifying a licensed provider (Ziss, 2015). If this is the case, it can be assumed that she is not the only employee who makes such a presupposition. It seems as though professional development days are needed so that the staff is better educated about scope of practice and policy so that the policy can be effectively enforced.

POST – 2A

As practitioners we take an oath to do right by all people and we represent to oblige by laws and regulations to help protect us and the community that we serve. I’ve worked in places where I have seen similar situations that I’ve had to report and I never second guessed doing so, because ultimately, we are protecting our patients. Authors N, BA, & LLB, state that patients are vulnerable to the unknown in medicine and it takes strong nurses and practitioners to advocate for their well-being, safety, and beneficence (N.L., BA, & LLB, 2018).

In the scenario with Stephanie, it is the assumption that she also has an understanding of her scope and how to seek further assistance even though the practice may be busy. The fact that she has been a stellar employee and efficient in her position does not render her the right to make a decision in renewing the patient’s prescription without authority. The simple fact of her making the judgment in renewing the prescription could have inadvertently hurt the patient. The patient could have had a later reaction to the medication, or have an interaction to another drug. These consequences would have fallen on the nurse practitioner (myself) that she appointed the renewal from.

Since the magnitude of situation is serious, I would recommend that Stephanie be dismissed from her position for the following reasons; Stephanie didn’t take responsibility in passing on the information needed by the patient, and she forged the practitioners prescription authority. I would also move forward to have an in-service in the practice to remind everyone working the importance of passing on vital prescription renewal and review office protocols for similar information. Last, Stephanie’s negligence could have resulted in a malpractice suit against the clinic and compromised my state board licensure including the physician I work for.