the micro ethical implications which are at the individual level are that the medical assistant violated the ethical principles of integrity, honesty and potentially put patient safety at risk.

Give a positive feedback to each of this post. Use proper citations and scholarly sources.

Abrupta Post#1: Based on the described situation, the micro ethical implications which are at the individual level are that the medical assistant violated the ethical principles of integrity, honesty and potentially put patient safety at risk. Legally, the medical assistant practiced outside her scope of practice and could face consequences for dispensing medication without proper authorization. The meso-level is the practice level. The ethical implications are that the practice is held responsible for staff actions. Legally, the practice could face repercussions for negligence with staff supervision that could result in loss of license, fines, or reputation damage. The macro-level is the system level. The ethical implications are concern for the organization culture or system that could have led to the behavioral occurrence. Failure to regulate and address systemic issues could lead to legal challenges.

To prevent recurrent issues in the future, staff should have training and reminders regarding prescription refill protocols and communication with patients. There could also be increased supervision and a checkpoint system, requiring provider confirmation before prescriptions are dispensed.

As a provider, I would further coach the medical assistant using open communication, active listening, and constructive feedback. I would make sure to explain actions and consequences in a nonjudgmental way to better understand any underlying issues, while also educating proper protocol.

According to Barrow et al. l. (2022), all change initiatives, regardless of size, can be broken down into three major phases which include pre-change, change, and post-change. Lewin’s theory of planned change incorporates three phases to successfully implement change within a system. The three phases include unfreezing, movement, and refreezing (Marquis & Huston, 2021). The unfreezing step includes the process of change preparation. During this phase, the leader must convince others that change is necessary to move forward in the organization. During the movement phase, the leader must strategically plan and implement change while creating a trusting relationship with staff by addressing stress caused by change. During the last phase, refreezing, the leader can assist the organization in regaining stability as changes are accepted, becoming the new norm. This model would be the most suitable for this scenario because it emphasizes the importance of preparing, successful implementation and ensuring it is engraved in the organization’s practices.

One potential barrier would be resistance to change by staff members. The medical assistance may have concern for workflow disruption or fear of increased scrutiny. Strong leadership and support from the providers can help facilitate change by establishing clear expectations, providing education resources, and reinforcing importance of following protocol.


Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2022, September 18). Change management. In StatPearls Publishing

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer.

Lourdine Post#2: The scenario is a wide-ranging matter that appears to be related to the illicit re-ordering of medicine, in which ethical and legal inquiries arise at all levels of healthcare. At the micro level, there are two main concerns: the immediate care provided to patients and the issue of loss of trust and security. Dispensing medications without seeing a provider is disapproved of apart from provider consultation. This raises concerns about patients’ safety and confidentiality. It also has legal implications of prescription fraud as well as medical malpractice(Balogun et al., 2024)Meso-level consequences entail implications for the healthcare team and organizational course of action, thereby eroding professional integrity and possibly causing internal conflicts among staff members. On the macro level, the factors may also reach beyond the healthcare system, affecting areas like compliance with local regulatory requirements and the reputation of the healthcare facility, as well as patients’ trust towards the general healthcare system.

To avoid any further occurrences of unauthorized actions, I suggest implementing extensive training programs that separate and consider individual roles of staff functions and responsibilities. It is mandatory that these include substantial training in healthcare legal and ethical rules that pertain to patient care and medication management. However, a culture of constructive feedback is a necessary step to be engaged in. Take an empathetic approach towards the conversation, ensuring you understand her point of view while also explaining the situation clearly enough to relate to your feelings(Balogun et al., 2024). The feedback must be specific, actionable, and related to the aspects of patient safety and compliance with all relevant laws. Here, there is the capability for open communication without the assignment of unfounded guilt. In this case, new knowledge can be learned without the constraints of time or space.

c. in implementing changes, I would apply Kotter’s 8-step process, which is about how to lead change. Through this model, a robust system is presented. It begins with convincing stakeholders that the change is necessary and forming the nucleus of the movement. Then, it involves developing a vision and strategic plan, communicating the change vision to all parties, empowering all parties to work towards the change, generating short-term wins, consolidating gains, and anchoring the changes in the organizational culture (Coon et al., 2020). This model strives to facilitate communication and buy-in at both management and lower-level approaches in reaching the goal and building an environment of accountability and security.

dOrganizational cultural change could be hindered by staff who may find the change process to be invasive or could be mistrustful, and decrease morale overall. Addressing this constraint must be done through transparent communication systems and collaborating with staff to hear their concerns and offer them a role in a process they can be proud of. One of the facilitating factors could be the established successful relationships and professionalism among these providers and the medical assistant (Coon et al., 2020). They can be brought on board to lead the new practice and ensure the emergence of a supportive environment for the changes to take place, stressing teamwork and a shared commitment to patient safety and ethics.


Balogun, O. D., Ayo-Farai, O., Ogundairo, O., Maduka, C. P., Okongwu, C. C., Babarinde, A. O., & Sodamade, O. T. (2024). The Role of pharmacists in personalised medicine: a review of integrating pharmacogenomics into clinical practice. International Medical Science Research Journal4(1), 19-36.

Coon, S. A., Hill, L. G., Hutchison, R. W., Arnold, L. M., Jarrett, J. B., Ottney, A. R., … & Bratberg, J. P. (2020). Mobilizing pharmacists to address the opioid crisis: a joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy. Journal of the American College of Clinical Pharmacy3(8), 1493-1513. 

Post#3 Barnes: Change is inevitable. We must change with the dynamic healthcare environment. These changes can be slow or rapid but nonetheless, require adapting. Adaptation requires successful models of change. When changes are necessary, we want the planned changes to be successful. Many times, it requires careful and thoughtful planning. Many planned changes fail due to poor planning, lack of motivation, poor communication, and excessively frequent change (Barrow et al., n.d.). We all know the impact of poor communication and know how effective communication can lead change effectively. One of the top challenges for nurse leaders is communicating and implementing constantly changing policies and all the same time, inspiring exhausted, frustrated, and overworked staff, failing efforts, or rejection (Collins, 2022). APRNs, as change agents, need to initiate and lead change by promoting new ideas, sharing a clear vision, and translating evidence into practice (Marquis & Huston, 2021). Change is important but sustaining the change is equally important. Enlisting key stakeholders, clearly communicating the rationale for change and the expected outcomes, and supporting the process during the change are requisite skillsets needed to lead effective change. It is a process, multiple steps to achieve and sustain change.

Dr. Barnes

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2022, September 18). Change management.

In StatPearls Publishing

Collins, R. (2022). Leading forward: Embracing feedback and moving toward authentic

positivity. Nurse Leader, 20(3), 270-272. 

the micro ethical implications which are at the individual level are that the medical assistant violated the ethical principles of integrity, honesty and potentially put patient safety at risk.

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