Nursing essay on Organizational, Political, and Personal Power/Organizing Patient Care

Nursing essay on Organizational, Political, and Personal Power/Organizing Patient Care

Types of power

Informal power refers to a leader’s ability to lead direct and achieve without any official leadership title. On the other hand, formal power is based on a person’s official position in an organization. In the case study, the clerk has formal power (Karam et al., 2018). He uses the organization’s power and policy to deny the nurse a copy of the home prescription and follow-up doctor’s appointment for the patient. The clerk does not use his leadership skills and proactive nature to deny the nurse but uses the rules and regulations to deny the nurse what he requested.

Alternatives for Action

The main issue in the scenario is that the clerk is refusing to hand over the patient prescription and follow-up report, and I need the report to plan for the care and follow-up of the patients. The main reason for refusal is because the patient wants to be discharged against medical advice. The clerk claim that the hospital has no obligation to provide the service to the patient since the patient has made his choice to be discharged against medical advice.  I believe that the patient has the right to her prescription because the doctor ordered them.  Additionally, if the hospital does not dispense the medications, the patient is not likely to access or have her prescription filled. The dilemma comes when the patient is about to leave and needs her discharge planning and prescriptions. The patient will probably not access the drugs.

There are various alternative actions I can take to assist the patient. The action I will take is to contact the physicians directly on behalf of the patient to send me the prescription list. Refusing to give the patient the list is considered as abandoning the patient. Regardless of whether the patient wants to be discharged against medical advice, they have a right to specific discharge instructions, discharge prescriptions, and follow-up appointments. If the doctor sends the discharge prescription and follow-up, I will educate the patient on the medications and discharge instructions to live a comfortable life and die with dignity. Refilling the medications may be an issue for the patient since insurance cover may not cover them. In this case, I will assess if the patient can purchase the drugs in another healthcare setting. If the patient is not able to, I may seek a waiver for the patient. If a waiver is not possible, I may discuss with the patient to prescribe cost-effective drugs that can at least boost the health and wellbeing of the patient.  The other solution is to advise the patient to go to another healthcare setting for discharge prescription. Each of the solutions has consequences. The first one may create conflicts between the management and the unit. This is because the patient is required to directly contact her physician. Facilitating the contact is wrong according to the organizational policies.

The action I would take is to facilitate the contact between the physician and the patient. These will allow the patient to access the prescription list and the discharge and follow-up instructions. The patient has the right to her prescriptions as they were prescribed for her use. Denying the information may be unethical and may create legal and ethical issues for the healthcare setting.



Karam, M., Brault, I., Van Durme, T., & Macq, J. (2018). Comparing interprofessional and inter-organizational collaboration in healthcare: A systematic review of the qualitative research. International journal of nursing studies79, 70-83.

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