A nurse is writing a prescription for a patient and signing the physician’s name.

Using the following scenarios, determine whether disciplinary action should or should not be taken and if so what sanctions would be implemented (NOTE: you may not have studied the appropriate law yet, in all situations, but your ethical instincts may still lead you to the correct response):

A nurse is writing a prescription for a patient and signing the physician’s name.

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An employee meets a patient in the supermarket and discusses the patient’s office visit earlier that day.

An employee is in the break room and is relating a joke that is of a sexual nature and a coworker overhearing the joke is embarrassed and offended.

A billing department employee discusses with a patient over the phone the possible payment plan options for the bill.

An employee has called in sick unexpectedly one time more than is allowed and coverage is short for that shift in the hospital.

A physician has already treated a patient when she realizes that the insurance policy will not be in effect for another week; she tells the front desk staff to change the date of treatment so that it will fall within the dates of coverage.

An employer asks an interview candidate whether or not she is planning on having more children in the near future and whether she has daycare established for her employment.

An employee has been given 30 days to improve work production along with additional training to aid him in his position, but after the 30-day period he is still not performing at the level of his fellow workers.

Sally is wearing casual dress clothing. The supervisor does not say anything to her, even though Sally is not in compliance with the dress code and other employees are held accountable to the dress code standard and are disgruntled over the situation.

A physician is sending all his patients to the radiological imaging center down the street; he has a partial ownership interest in the facility.

Discussion

What is the difference between the types of feasance?

Give examples for each type of feasance as it may pertain to the medical field.

What If?

A patient is seen by a gastroenterologist and it is recommended that the patient undergo a colonoscopy procedure for diagnostic purposes. The physician reviews the risks of having the procedure done as well as the consequences of not having the procedure performed. The patient signs an informed consent form, and the medical assistant/ nurse reviews the preparation instructions the patient should follow before the procedure as well as other details. In the instructions, it is clearly noted that the patient should stop taking any medications, such as aspirin, that can cause bleeding problems at least 7 days before the surgery. However, the patient continues to take a single 81-mg dose of aspirin each evening, dismissing the possible complication that this could have during the procedure. On the day of the procedure, the physician records that the patient has confirmed following all the preoperative instructions. Afterward, the patient has a bleeding complication in response to the procedure, is hospitalized for this complication, and sues the physician.

What example of defense is this case?

Who is responsible in this case?

Was the provider/physician negligent?