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Advanced Practice Nurses Role Perspectives

Advanced practice nurses (APNs) are expected to act ethically and professionally whenever providing medical services to their patients. They should also apply the major standards of practice in their respective settings. The paper presented below discusses the issues surrounding a malpractice action filed by Yolanda Pinellas. The discussion examines the case from the perspective of these APN roles: administrator, practitioner, and educator.

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Standards of Care

The presented malpractice action case reveals that Pinellas developed necrosis on her hand. This resulted in a surgical procedure and reconstruction. She had a permanent loss of function and deformity in three fingers. The outstanding fact is that the lawsuit is reasonable and the patient should receive appropriate compensation. Professionals in the major APN roles will definitely examine this issue from different perspectives. For a nurse administrator, the violated standard of practice would be that of professional relationships and leadership (Barlow, Hargreaves, & Gillibrand, 2018). This is true since the practitioner failed to establish the best relationship with the care delivery team.

A nurse practitioner would acknowledge that these two standards of care were violated: accountability/responsibility and client-centered relationship. The rationale behind this argument is that the nurse in the institution failed to remain accountable and establish the best relationship with the patient to deliver positive health results (Wong, 2015). A nurse educator would argue that the practitioner violated the individual self-regulation standard. This was the case since the caregiver failed to act in accordance with his or her scope of practice.


Several violations are evident or deducible from this case. The first one is that the practitioners ignored the existing or established standards of practice. Secondly, the health administrator failed to implement superior mechanisms for reporting errors and responding to emerging issues (Nickitas, Middaugh, & Aries, 2014). Although the issue of nursing shortage is evident in this case, the physician failed to make drastic measures after receiving the update. One of the nurses also chose to infiltrate the IV instead of providing adequate support.

From the above analysis, it is evident that several individuals were responsible for such violations. The nurse administrator failed to implement appropriate mechanisms to address the challenge of nursing shortage in the unit. The use of float nurses in this clinic can be described as the administrator’s fault. The nurse who pressed the button is also responsible. This is also the same case for the physician who received message about the dislodged IV. The leader in the institution also failed to act on the information presented by the risk manager since many nurses were working overtime (Wong, 2015). The facility’s nurse educator is also responsible for the above violations since he/she did not provide appropriate insights to guide the targeted nurses.

Risk Management Steps

A nurse practitioner and administrator can consider a number of risk management steps to prevent such an incident from taking place. They can do so by introducing superior practices whereby nurses focus on the standards of practice whenever providing services to their patients (Nickitas et al., 2014). The transformation or improvement of the institution’s culture can create the best environment for supporting the needs of more individuals.

Risk management strategies can be considered to prevent a similar incident in the future. Since this occurrence endangered and changed the life of the patient, these professionals can perform a procedure called root cause analysis (RCA). This is a powerful strategy that will guide these professionals to understand what went wrong and who was responsible for the occurrence (Wong, 2015). Such an initiative will ensure that a similar error does not occur.

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The second step is to introduce superior programs aimed at educating more practitioners about the risks and issues that can result in sentinel events. A nurse educator will have numerous roles to play throughout this phase. Such a strategy will ensure that all nurses are aware of the outlined standards of practice and focus on their duties (Nickitas et al., 2014). The third step is to introduce superior technologies that can alert different leaders, physicians, and administrators whenever something goes wrong.

Another powerful strategy or step is to implement the use of checklists to guide practitioners whenever providing medical services or care to their respective patients. This approach will ensure that every condition or situation is supported using appropriate procedures.

The introduction of decision support systems (DSSs) can deliver positive results. The transformation of a unit’s culture is an evidence-based strategy that can result in superior procedures to meet patients’ needs. Such a strategy can empower practitioners to communicate with each other more effectively, form multidisciplinary teams, and identify problems before they result in malpractice lawsuits (Barlow et al., 2018). The final step is for practitioners to collaborate and work as teams to overcome the negative issues associated with the current problem of shortage.


When APNs fail to act in accordance with the stipulated standards of practice, chances are usually high that sentinel events will occur and expose the professionals to malpractice lawsuits. The case of Pinellas reveals that practitioners should implement evidence-based strategies to prevent similar incidents. Such an approach will safeguard more institutions against malpractice lawsuits and meet patients’ health needs.


Barlow, N. A., Hargreaves, J., & Gillibrand, W. P. (2018). Nurses’ contributions to the resolution of ethical dilemmas in practice. Nursing Ethics, 25(2), 230-242. Web.

Nickitas, D. M., Middaugh, D. J. & Aries, N. (2014). Policy and politics for nurses and other health professionals (2nd ed.). Burlington, MA: Jones and Bartlett Learning.

Wong, C. A. (2015). Connecting nursing leadership and patient outcomes: State of the science. Journal of Nursing Management, 23(1), 275-278. Web.

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