You are a family nurse practitioner working in an outpatient primary care office of a large hospital system

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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 on 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
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.
A scholarly resource must be used for EACH discussion question each week.

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  1. Potential Issues for Healthcare Team Members from Office Conflict:
    • Medical Assistant (MA): The MA may experience stress and distraction due to ongoing conflicts, affecting job satisfaction and performance. The failure to report critical patient information could result in compromised patient safety and potential legal consequences.
    • Nurse Practitioner (NP): The NP may face challenges in providing quality patient care and maintaining focus due to the disruptive work environment. The lack of effective communication from the MA could lead to delayed or missed critical information, impacting patient outcomes.
    • Medical Director: The Medical Director may struggle with staff management and maintaining a positive practice culture. Chronic conflicts among staff members can affect overall productivity, hinder effective communication, and potentially lead to increased turnover.
    • Practice: The practice, as a whole, may experience decreased efficiency, compromised patient safety, and potential damage to its reputation. Ongoing conflicts can contribute to a toxic workplace culture, affecting staff morale and patient satisfaction.
  2. Ethical and Legal Implications:
    • Medical Assistant: The failure to report critical patient information raises ethical concerns regarding the duty to prioritize patient safety. From a legal perspective, negligence or malpractice claims could arise if patient harm results from inadequate communication.
    • Nurse Practitioner: Ethical concerns include the obligation to advocate for patient safety and the need for effective communication within the healthcare team. Legal implications may involve liability for patient outcomes if there’s evidence of inadequate supervision or communication protocols.
    • Medical Director: Ethically, the Medical Director has a responsibility to address and mitigate workplace conflicts, fostering a positive culture. Legally, failure to address ongoing conflicts and their impact on patient care could lead to negligence claims against the practice.
    • Practice: The practice could face legal consequences for compromised patient care due to internal conflicts. Ethical concerns involve the responsibility to provide a safe and effective healthcare environment.
  3. Strategies to Prevent Further Episodes:
    • Implement a formal conflict resolution process.
    • Provide team-building activities and communication training.
    • Establish clear communication protocols for critical information.
    • Foster an open-door policy for staff to express concerns.
    • Regularly assess and address workplace satisfaction and stress levels.
  4. Leadership Qualities for Positive Change:
    • Lead by example in promoting positive communication.
    • Advocate for a culture of collaboration and respect.
    • Address conflicts promptly and impartially.
    • Encourage ongoing professional development and training.
    • Foster a sense of teamwork and shared responsibility for patient care.
  5. Scholarly Resources:
    • Conflict resolution in healthcare: “Conflict Resolution in Healthcare Teams: Understanding the Power of Positive Approaches” by Overton, L. (2017).
    • Leadership in healthcare: “Leadership in healthcare organizations: A guide to Joint Commission leadership standards” by Rubin, B. A., & Mosenkis, J. (2016)
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