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Substance abuse in the nursing profession
Substance abuse in the nursing profession
Substance abuse in the nursing profession
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Reporting Party (RP) stated that resident Richard Soto (age 63, DOB: 08/29/53) was admitted to St. Mary's Medical Center for overdsing on lithium and was discharged on 1/1/17. It was reported that 12 hours later, the resident was admitted agin to the hospital for overdosing on pain medication. RP is concerned that resident's medication is not being monitored. RP stated that the resident's medication should be locked and inaccessable to the resident. Staff denied resident having any access to pain medications. RP stated that the resident was "lucky with these last two overdoses and there is concern that the client may not be lucky a third time."
In the case study identify the incident and explain the problem that might trigger a root cause analysis. In this case study, a patient admitted to the intensive care unit (ICU) with septic shock requiring vasopressors that suffered an MI in the course of his treatment due to vasopressin overdose as the incident. The problem that triggered a root cause analysis was likely related to a log increase in the dose of vasopressin because of a prescribing error, pharmacy issues also figured prominently in this error, the computerized physician order entry (CPOE) system that did not eliminate medication errors and domino effect to the nurse that started the medication that eventually caused the patient to have an MI. The patient in this case was receiving the medication vasopressin, at a dose of 0.4 units/min, a dosage used for gastrointestinal hemorrhage and variceal bleeding rather than the correct dose of 0.04 units/min for treating shock. The vasopressin order was incorrectly written by a resident physician after he received a verbal order from his supervising critical care fellow (Flanders, S. & Saint, S., 2005). The dose that was used for the patient was so high that it acted as a vasoconstrictive agent to reduce the blood flow and facilitate hemostatic plug formation in the bleeding vessel thus causing the MI (complication of high dose vasopresson infusion) (Cagir, B. & Katz, J.). Furthermore, the nurse caring for this patient administered the incorrect dose of vasopressin as a result of the domino effect. In fact, the incorrect dose was given for more than 16 hours, which means that more than one nurse was involved in the error. It was not until a nurse was discussing the medication dosing with nursing students that the incorrect ...
Bourgeois notified of the decision to detain client for Grave Disability and was in agreement with client being placed for further psychiatric care. Dr. Bourgeois requested the name and contact information for help in facilitating client being transferred to an LPS designated facility, due to being unable to place him on multiple occasions. This writer contacted Supervisor Robin Boscarelli regarding this issue. It was decided that a member of the Treatment Team will be reaching out to the Hospital Unit Clerk, Gina later this morning. Dr. Bourgeois was in agreement with this plan. Client's Clinic to be notified via email of this Crisis
.... “The Strange Case of Marlise Munoz and John Peter Smith Hospital.” n.p.. 28 Jan. 2014. Web. 08 Feb. 2014.
Registered Nurse Pausits, a defendant out of the many involved with Parson’s case, has failed to provide Randy Parson with the correct prescription drug during his stay at Standish. The Plaintiff wanted to prove that she unsuccessfully administered medication to Randy Parsons and that a reasonable jury can conclude the fact Pausits was aware of the risks to Parsons. The court has reversed the grant of summary judgment to Nurse Pausits, because this case would rise to the level of deliberate indifference. Plaintiff Parsons revealed that Pausits perceived facts to infer substantial risk to Randy Parsons and drew the inference. She had to state she was aware, which she did, of a substantial risk. Evidence has shown that Nurse Pausits could have gotten Dilantian for Randy Parson if she viewed the situation as an emergency. Pausit’s case has discovered confirmation that she administered 100mg of Dilantin to Randy Parsons August 27, at 6:00 p.m. However, in Randy’s toxicology report, no Dilantin was shown in his body for 3 days before his death, which was August 28. Wellbutrin was shown in Randy’s body instead of Dilantin, which is a form of an anti-depressant that helps people suffering from seizures and can prevent causing a seizure. Displayed that Pausits signed Randy’s Medication Administration Record (MAR), when the prison log showed that Registered Nurse Alexander performed the medication August 27, raises a red flag as to who performed the medication and what prescription was given. The Plaintiff provided enough evidence towards Pausits in that she has unsuccessfully administered the medication to Randy and that Pausits was aware of a substantial risk to Randy Parsons. Because of this, a jury can place more significance on the t...
CCIB Intake received referral #0277-5021-7355-6088130 dated 2/18/16 from reporting party Ignacio Gonzalez Lead Residential Counselor. It was reported that residents Terri'Aunna Unique Reliford DOB: 9/1/00 and Endia Keairra Wilson DOB: 9/6/01 went AWOL (date not provided). Resident Endia returned to the facility on 2/17/16 and stated that Terri'Aunna was with and 18 year old male named Roy Smaer IV. Endia reported that Roy is a "meth head" and lives in Long Beach. According to the reporting party Endia stated the last time she saw Terri'Aunna (date unknown) she appeared tired, had bags under her eyes, looked high and not bathed. Endia stated that she and Terri'Aunna were with other men named DJ, Carlos, Jamar, Keonte, and Michael (all last names
Lithium and Bipolar Disorder INTRODUCTION The drug lithium has been used for a variety of disorders such as gout, diabetes, and epilepsy for over 100 years. It was not until 1949 when John Cade discovered that lithium had a calming effect on guinea pigs that the possibilities of it being used for mania were explored (Paykel, 1992). Since then, lithium has been established as one of the primary treatments for manic depression disorder. In the body of this paper we will explore the chemistry of lithium, the synaptic transmitters involved, the parts of the neuron affected, the inhibitory and excitatory potential changes, the ion channels effected, the physiological changes, the primary behavior changes, the side effect behavior changes and the effects reported by users. CHEMISTRY Lithium is a chemical element found in group IA of the periodic table, along with sodium, rubidium, and cesium.
Bipolar Disorder, an illness in the brain where it controls someone or something to have mood swings, depression, and thoughts on others and other things. Bipolar Disorder is the common name for Borderline Personality Disorder, it can be distressing, not only for the person with the disorder, but for the people around them. Persons with Bipolar Disorder have a difficult time controlling their emotions and many times are in a state of upheaval. Childhood experiences or a brain dysfunction are potential reasons why. Bipolar Disorder can be changed or helped by medication, therapy, and counseling. Bipolar is not an illness that can stand alone it is changed by other variables. Bipolar Disorder, is something not to be mess with. In (MANNING, JS.
In August of 2001 Robert Ray Courtney was arrested in Kansas City, Missouri and charged with diluting drugs used to treat cancer patients. Courtney’s actions not only violated criminal and civil laws but they shattered the ethical code and the oath he took as a licensed pharmacist. His actions left many people wondering why anyone would commit such a horrible act, let alone a trusted pharmacist who was providing medication to patients whose very lives depended on him doing his job.
Bipolar Disorder (BD) affects about 2 million people in the United States in any given year. This troubling mental illness can disrupt a person’s daily life and often leads to thoughts of suicide or death. People who get inappropriately diagnosed with BD often get treated with medication that is unnecessary and potentially harmful. BD has become one of the most over diagnosed mental disorders, this due to the overlapping features between BP and other personality disorders. The creation of a universal assessment technique and reeducating the public and professionals would reduce the over-diagnosis problem.
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
As the EAI team was discussing Molly’s case, one of the ED Residents made a few telephone calls. Molly’s PCP reported that during her last visit about 2 weeks ago, Mollie was alert and able to respond to questions appropriately. He confirmed that Mollie’s daughter and son in law have experienced psychiatric problems, adding that the son in law has expressed anger regarding Mollie’s living arrangements. The home health care agency was contacted. The RN and aide both report they have never met the son in law and have had very limited contact with Mollie’s daughter. When contacted by telephone, the daughter provided no explanation for Mollie’s extensive bruises noted on admission to the hospital. The daughter stated that Mollie did not fall, but in fact lowered herself to the floor in an effort to draw
There are several people every year that are diagnosed with a mental disorder. In the world’s entire population, more than one percent of people have been diagnosed with schizophrenia (Brain and Behavior Research Foundation). When thinking of the billions of people in the world, it might not seem like that many people but once the number of those diagnosed is calculated it seems much larger. Currently there are more than seventy million people in the world that have been diagnosed with schizophrenia, only diagnosed. There are probably several more people who have this disorder and have not been diagnosed or are unable to obtain the resources to be diagnosed.
Bipolar disorder, also called a manic-depressive illness, is a common disorder which causes mood swings, lasting periods of depression, and episodes of mania. “Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood” (National Institute of Mental Health [NIMH], 2008). A person becomes more goal-oriented and has grandeur visions of success. Patient M shows all these symptoms while talking to her friends and professors in college. She describes herself as a person who is above the two standard genders, what she calls a “third sex”, and who switched souls with a senior senator from her state. The latter belief inspires her to start a political campaign and achieve a high position in the government. She also suffered from depression in the past, which lead to contemplations about suicide at one point. Besides showing all appropriate symptoms, her environmental and inheritance factors point out that she has predispositions to develop the bipolar disorder.
Eric Beck meets criteria for Bipolar 1 disorder. He shows some signs of General Anxiety Disorder as well. Anxiety disorders are the most coming co-occurring disorder with Bipolar 1. To be diagnosed with Bipolar 1 disorder you must meet criteria for Major Depressive Episode and Manic Episode. Eric meets criteria for part A of Major Depressive Episode due to his extensive history of depression. He stated that “I suffer even when doing things, I should enjoy.” He often had feelings of guilt or worthlessness. Along with this Eric struggled from a lack of concentration. He also had recurrent thoughts of death and has tried to commit suicide.
There were many ethical issues within this case; the first indication of an ethical problem was the administration of an incorrect medication to the patient. The doctor, administration, and providers involved in the care of the patient must decide what is ethically moral when informing the patient. I believe that it is the patient’s right to know that she received the wrong medication for a number of days. Although no major medical consequences occurred, I believe this