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Hcs 335 Ethical Case Study- Jerry Mccall

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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 supervising physician and surgeon or podiatrist must be on the premises in order for the medical assistant to perform those non-invasive technical support services” (State of California, 2010). Jerry is unable to refill the medication because he is not trained or certified to refill medication. He cannot issue the refill because he has not asked Dr. Williams for approval. If Dr. Williams was in the office and Jerry asked him if he was able to approve the refill request for the Valium and Dr. Williams said yes, then Jerry would be able to call the pharmacy and submit the refill approval. A doctor or nurse practitioner working under a doctor are the only people who can approve a medication prescription. If the patient was requesting a refill for a medication to control his high blood pressure Jerry would not be able to refill this medication either. The reason for this is because he is not certified to refill medication without a doctor’s approval. Again he must ask the doctor before calling in a refill for a medication. According to Fregmen, 2009, “Under the doctrine of respondeat superior, or let the master answer, the employer is liable for the consequences of the employee’s actions committed in the scope of employment. The employer may not have done anything wrong, yet still is liable” (Fregmen, 2009 pg. 133). With that being said because Jerry is working outside of his scope of practice and the doctor is not present he will not be protected from a lawsuit under the doctrine of respondeat superior. The advice I would give to Jerry is to not refill the Valium for the patient. Jerry needs to explain to the patient that regardless if the patient is a personal friend of Dr. Williams he is unable to refill the medication. Jerry should explain to him that he can call Dr. Williams and explain the situation and if Dr. Williams approves the refill request then it will be refilled. If I were Jerry I would either call Dr. Williams if he is taking calls at that particular time. I would then explain to him what the patient stated. If Dr. Williams was not taking calls at that particular time I would wait until he returned. I would explain to the patient that Dr. Williams is out of the office and unable to be reached at this time, but I would ask him as soon as he returns. First off, Jerry is not licensed to prescribe medication so he is breaking the law. If Jerry was to refill this medication numerous things could happen; 1. The patient can sue Jerry and Dr. Williams and state that he was given a medication that he was not supposed to take. 2. Jerry can be fired from his job. Since he is not licensed to prescribe medications Dr. Williams can chose to fire him since Jerry is a liability to his company. A method Jerry may use next time he is confronted with a situation like this would be “The Problem Solving Process: - Problem Definition. - Problem Analysis. - Generating possible Solutions. - Analyzing the Solutions. - Selecting the best Solution(s). - Planning the next course of action (Next Steps)” (Problem Solving Process, n.d.)
The problem solving process will help him to prevent problems like this from reoccurring. The next time an event like this happens Jerry will not have to think twice about it.

When situations like this occur in a health care setting employees may think that they can do things like refill a medication because most of the time the physician approves it. Choosing to refill medications that have not been approved by the physician is just setting yourself up for failure. Something to always think of when working is, if the hair on the back of your neck stands up then stop what you are doing. I have been told that by my Licensed Vocational Instructor who is a Registered Nurse and also told by my boss who is a Nurse Practitioner. Jerry needs to think before he acts and if he is not able to perform a task because his scope of practice does not allow him to he must ask for permission.

References:

Drugs.com (2013). Valium (diazepam) Uses, Dosage, Side Effects - Drugs.com. Retrieved November 1, 2013,

from http://www.drugs.com/valium.html

Fremgen, B. F. (2009). Medical law and ethics (3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Rxlist.com (2013). Benzodiazepines Drug Class Information on RxList.com. Retrieved November 1, 2013, from

http://www.rxlist.com/script/main/art.asp?articlekey=94661

State of California (2010). Welcome to the Medical Board of California - Medical Assistants.

Retrieved November 1, 2013, from http://www.mbc.ca.gov/allied/medical_assistants.html

The Problem Solving Process. (n.d.). Retrieved November 1, 2013, from

http://www.scribd.com/doc/21216055/The-Problem-Solving-Process

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