Tonight we were dispatched to take a pt from Mission to Saint Joes. The pt was to be taken to 708 Saint Joes. We arrived at the room and moved the pt to the bed. After getting the pt in bed a nurse came by and was in a panic telling me that "I don't believe this pt is supposed to come here". I followed him to the nursing station where he left me with the secretary. While I was there she was talking on the phone and asked the person she was speaking with " what room do you have for (pt's last name)", she then said "ok" and hung up. She then told me that that was the house nurse (who she was on the phone with) and they informed her that the pt is to be taken to 624. I told her to hold on and spoke with my partner asking what I should do. He told
The medical assistant I was shadowing came running in and told me to follow her, I didn’t ask any questions and followed.
I agree with you that the nurses violated provision 9 of the nursing code of ethics. Nurses have an obligation to themselves, their whole team and to the patients to express their values. Communication is key in a hospital, so everyone knows what is correct and what isn’t within the workplace. In order to have a productive, ethical, positive environment. These values that should be promoted affect everyone in the hospital, especially the patients, and can have a negative outcome if those values are not lived out. Nurses have to frequently communicate and reaffirm the values they are supposed follow frequently so when a difficult situation comes along that may challenge their beliefs they will remain strong and their values will not falter.
I cared for a 76-year-old end-staged chronic obstructive pulmonary disorder patient who was admitted for respiratory distress. The doctor requested that my nurse and I get the family together for a family meeting. During the meeting, the doctor communicated to the patient and his family members that the patient will be palliative and no longer be in the ICU. The family members were concerned about the transfer of care to the medicine unit, what to expect from palliative care and other options for care. This scenario did not go well because the patient and family would have benefited from a palliative nurse with expertise, respiratory therapist to discuss other options, pharmacist about medication change if needed, social worker to help guide the family through end of life care for their father. In addition, there was no collaboration with interprofessionals prior to the family
Nurse A seemed confident and calm while nurse B appeared tired. With the first patients, I noticed that both nurses were asking for first and last name and confirmed the information with the picture in the computer and the medication cup. After a few minutes, I turned my attention to nurse B because I noticed she did not ask a particular patient for his name. Instead, she relied on the name provided by a patient care technician. When she was about to give the medication to the patient, nurse A noticed that the patient on the computer screen was not the patient on the counter. She immediately told nurse B “ That is not Mr… girl ” and nurse B responded while laughing “ He looks exactly like …, I need to get some coffee ASAP”. The patient immediately realized what happened and told nurse B his name. After that, nurse B reached for the right cup and administered the medication to the patient. Even though a medication error was not committed and no harm was inflicted to the patient, by violating important QSEN competencies this incident could have caused a negative patient outcome.
I was with a 71-year-old male patient in an emergency room (ER) at a community hospital. The patient had been hit by a car while on his bike. In the accident, the pt had slid on the hood of the car and then across the asphalt, so he had abrasions down his right side. However, miraculously, the patient had no broken bones and he was alert, oriented, and ambulating. During the visit to the hospital, a nurse brought in a vaccination vial and a syringe and started drawing up the vaccine while stating, “Have you had a tetanus vaccine? You need this shot. I noticed you haven’t had one recently.” The patient said “no, no, no shots. I don’t want that.” The nurse then attempted to use humor stating “it’s no big deal, it’s just a little pinch.” This comment towards an older gentleman, who knows what a shot feels like seemed condescending to me. The patient said, “no, thanks.” The nurse then said “ok, it’s your right to refuse” and left. I was dismayed and critical of the interaction and made a mental note to handle things differently should I encounter similar circumstances in the
Reporting party (RP) stated that she visits her friends at the facility almost every other day. Her friends are a married couple who reside in room #215 (RP did not provide their names). RP stated that the facility is short staff and that often times, the residents have to wait a long time for assistance. RP stated that yesterday (05/20/18), there was just one caregiver on the floor. RP stated that there are usually 2 caregivers per floor. The wife ambulates with a walker and the husband is wheelchair bound. RP stated that it took over twenty minutes for staff to take her back to her room from the dinning hall. Staff finally took her to the restroom, but the husband remained downstairs and waited even longer. RP stated that somehow, he was
It was a quiet and pleasant Saturday afternoon when I was doing my rotation at the surgical medical unit at Holy Cross Hospital. It’s time to get blood sugar levels from MM, a COPD patient. His BiPAP was scheduled to be removed before his discharge tomorrow. When I was checking the ID badge and gave brief explanation what I needed to do. The patient was relaxed, oriented and her monitor showed his SPO2 was 91, respiratory rate was 20. His grandchildren knocked the door and came in for a visit. I expected a good family time, however, the patient started constant breath-holding coughing and his SPO2 dropped to 76 quickly. With a pounding chest, the patient lost the consciousness. His grandchildren were scared and screaming,
Another responsibility of our RRT is that they do “computer rounding”. During their computer rounding, they look at each unit to see how many patients are on the unit, check to see if patients are on the correct precautions, and also to identify any acute changes that the primary nurse has missed or has not addressed. One way they are notified of an acute change is by an assigned Rapid Response Number. Anytime a patient has a low, high, or any type of critical value vital sign, lab result, or radiology result, the system alerts the RRT and if a patient is assigned a number 5 or higher, rapid response has to immediately contact the primary nurse. As a floor nurse, sometimes it can become hectic caring for a heavy patient load and sometimes things can be missed, vital signs can be incorrectly entered, or it is possible a nurse is not aware of situation. I know personally I was recently contacted because a multi-care tech (MCT) documented a patient’s oxygen saturation as 79%. RRT immediately contacted me and questioned me about the result. At the time, I did not know of oxygen saturation level because I was still doing my medication pass and was not notified by the MCT. Thankfully after re-checking the patient and speaking with the MCT, we actually realized the MCT charted 79% instead of 99%. However, if it was correct, hopefully the swift and immediate action taken
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
Before the incident, I delivered my nursing care well. I am pretty sure nothing is going to happened and everything will be fine as all the patients are stable and we have enough staff nurses on duty. I was also thinking that my shift will end in a short while.
During my time in the Critical Care Unit, I was able to observe Kylie, who is a RN. She has been working in the CCU for two years. Kylie became a RN by receiving associate's degree, and then later went back to school and received her BSN. Kylie started working as an RN before returning to school to receive her BSN. My day in the CCU was a pretty mellow day, not much was going on. There were only around 10 patients in the CCU while I was there, the CCU can hold up to 16 patients at one time. Most of the patients admitted to the CCU were elderly patients who had a hard time breathing. For the patients who had trouble breathing,the respiratory therapist would come to their rooms and would perform breathing exercises with them. There were two other
The individuals involved in error should not be punishing but we all must learn from those mistakes by improving the system. In the case above, a root cause analysis was conducted as part of the learning and improvement process. There were a few breakdowns in the system noted that led to this sentinel event. A large part of the issue was related to the utilization of the chain of command by the nurse. Another problem was attributed to the comfort level of the nurse in reaching out to the next person in the chain of command. A final concern was noted regarding why the resident did not come to assess patient after the first time when he received the call from the nurse. Rizzo (2013) writes that we must remain open to anyone who questions the safety of care being provided and we must foster open, honest communication among the multidisciplinary team members. Furthermore, the healthcare systems cannot build a fear of retribution for these mistakes in their employees if they want to build a culture of
At the same time of this occurrence there were other things that went on pertaining to transference and counter transference. The Intern and I definitely had some type of strong transference and counter transference going on. There was a clash of personalities between the intern and me. We totally did not get along. I felt uneasy and that she did not want me there in the room with her. Why? I thought that maybe she felt challenged. I don’t know, but I felt I asked the patient questions that she forgot to ask. I also gave her my opinion about treatment principle, which I do not think she appreciated. With my previous interns, I was very much part of the intake and treatment process. The interns and I would ask questions. If one forgo...
I had stated "I didn't feel comfortable taking it" because I wanted to know if Robert had mentioned to upper management about our solution to the problem. Which is I'll be a back up tech to give Josue and Homer a weekend off each. He then called josh and put him on speaker and asked Josh " josh did I mention to them about Josue and Homer not wanting Chris to be on call" josh then stated "yes" Robert then stated "you see there it is" I then asked "but did you mention that I would be in rotation as a back up tech on the weekend." Robert then got upset and said to josh "nevermind josh this isn't going to change. Sorry for bothering you." And hung up the phone. I then finished my lunch and went into the warehouse to sanatize. Robert then called me into the office again. Telling me to do the the driving course. I tried to explain to him I didn't feel comfortable. Robert was the phone with a nurse at this time. I then told Robert "I would wait till he was off the phone." He stated that he "was on hold" I stated again that "I would wait until he's not on the phone." Robert then stated "you're making me want to hang up on the nurse." Robert started to get aggressive after he hung up on the nurse. I mentioned "I didn't feel comfortable taking the test until I got the confirmation that he mentioned our solution to upper management." Robert began to get upset and started yelling at me. I backed up two feet because I felt threatened by his anger. I asked "what can I do to get confirmation? Can email them and tag you in the email?" He then stated " No, you are refusing to listen" then he started calling Danny because he wants to get the approval to write me up. But at this point I'm sure he has convince Danny that I am a bad employee and that I'm influenced by others. I repeatedly stated "it's not that I don't want to take the course sir, it's just that I don't feel comfortable taking it with
The nurse insisted on calling her sister to be there for her when she wakes up. 10-15 mins later, paramedics and firefighters arrive at the scene and acted on trying to get her to respond, while I am getting the wheel chair in case she wakes up so she can just hop on and go home. As time go by she started showing signs of coming back to being conscious & out of nowhere she started busting out crying all over us & started thanking us. After she got done being emotional from the incident that took place, we put her in the wheel chair & we took her to the car & prayed she’ll go to a doctor to get checked out. Her mom was so thankful that we assisted helping her daughter with her medical problem while everyone just stepped over her and went to class. Just hearing her mom say that we made her day by helping her daughter made me realize that we are helping one each another may show how of a caring person you are. One person told me that “strike back against the selfishness and greed of our modern world, and help out a fellow human being today. Not next month,