The first thing I would do is address the matter directly with Stephanie, I would find out how many times and over what span of time she has sent in prescriptions for patients without consultation, under my name and any other ANP or physician in the practice. I would also inform her of the scope of practice and the consequences of her actions. I would then have to do possible damage control by contacting each patient that was given a prescription by Stephanie and reevaluate them. If her actions caused any harm to a patient I would then take the matter to my group and deal with the problem on a higher level. For some allied health professionals, the combination of temptation and opportunity is too great. With ready access to prescription pads, or having been entrusted with authority to phone-in prescriptions to the pharmacy for their employer’s patients, some health professionals abuse the status (McCarty & Wynn, 2014).
According to McCarty & Wynn (2014) prescription fraud, frequently referred to as prescription “diversion” by law enforcement agencies, is illegal under both federal and state laws. Individuals, who unlawfully obtain prescription drugs usually are prosecuted in state courts, although in more serious cases the federal government may prosecute the offender in lieu of, or in addition to, state criminal proceedings. The Food and Drug Administration is the agency primarily responsible for classifying drugs as available by prescription only. The FDA acts according to its responsibilities under the Federal Food, Drug and Cosmetic Act. The FDA handles some of the enforcement work under the Act. and in cases of prescription fraud can impose a penalty of up to a year in jail and/or a fine of up to $1,000. However, states have complementary laws governing dispensing of prescriptions and imposing penalties for abuse and fraud to patients, after informing Stephanie of these consequences I would hope she would continue her actions (McCarty & Wynn, 2014).
POST – 2B
This situation violates the nurse practitioner and medical assistant’s scope of practice. The ultimate responsibility falls on the nurse practitioners. The nurse practitioners are responsible for the diagnosis, and treatment ordered. Since this order for the antibiotic was sent under the NPs license, the nurse practitioner is responsible for it. The first intervention is to phone the patient to apologize and tell him/ her about the circumstances of this occurrence. The nurse practitioner has o assess the patient for any complications or side effects, and to remind him/ her that he/ she should call the office if the symptoms worsen. It is also important to tell the patient what are the resolution steps that were taken and that the medical assistant was warned about this serious offense and what disciplinary actions were taken.
It is also important to discuss with the medical assistant what are the rules that will change with regards to prescriptions and that he/ she needs to follow. She has to fully understand that a second occurrence will be reported to the employer and possible grounds for termination and reportable to the board of nursing. This information is not meant to scare the medical assistant, but to help her understand the seriosity of this occurrence.
Going forward, the nurse practitioner should require the medical practitioner to report any prescription requests. It would be helpful to create a log in which the medical assistant can track all the new requests along with the symptoms reported by the patient. The log can be checked by the nurse practitioner every hour in between patients and he/ she can write the order that he/ she would like the patient to be on. According to Rim, Thomas, Hatch, Kelly, and Tyler (2018), having a centralized prescription refill system will save provider time, and will provide a shorter turnaround time for the refills.