This week we had an officer working whose S11 had expired in LMS. The officer reported to medical and complete his S11 examination prior to his expiration date. The officer was told by the medical staff that before they could complete his approval he needed to follow up with his primary care physician to confirm a pre-existing condition was being treated and controlled by the doctor. The officer was asked to have his primary care physician forward the documentation to TVA’s medical and once this was done they would sign off on the TVA documents completing the officers annual S11 evaluation. The officers asked the medical staff to send him an email with her request for the additional documentation for which she did. However the nurse never
Answer: In this particular case, I would address my concerns of left behind documentation with the physician of care of this patient. Typically in an ER setting, when this occurs the physician immediately contacts the patient himself, or he is unable to he then gives the charge nurse on duty instructions to taking care of this matter.
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
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
In his translation of The Saga of the Volsungs: the Norse Epic of Sigurd the Dragon Slayer, Jesse L. Byock compiles many versions of this famous Norse epic and creates a very important scholarly work. Of special importance is the introduction, which provides a central working background to base readings upon. There are several themes echoed throughout the translation that reflect accurately on this portion of history. Byock does a superb job of illustrating these important aspects in his work. While the tale Byock tells is a fairy-tale handed down by generations of families, within the reader can find tell-tale signs of important aspects of Norse culture. For instance, important aspects of family life and the role of men and women surface. Likewise, the importance of wealth and material possessions on the power and prestige of a king is also evident.
Also, this case is a clear example of the nurse’s responsibility and accountability to act independently regardless of the physician’s order when this order is not safe for the patient. If the nurse has any objections to an order, the nurse has the obligation to question the physician. By not doing so, the nurse violates the nurse-patient relationship and puts at risk the patient’s safety. In a situation, in which a physician’s order puts the patient at risk, the nurse has the obligation to exert her professional judgment and withdraw from rendering services ordered by the physician (Wolf, 1986, p. 222-224).
b. The doctor cannot transfer the care of a patient or an associate without the patient’s consent.
When a patient is seen in the ED for a wound, the doctor generally starts the patient on antibiotics before the results of the wound cultures are in. Once these results are in, the PVRN is responsible for making sure the antibiotic is appropriate to treat the patient. If it is not, the PVRN must contact the patient’s primary care physician who is then responsible for making sure the patient is put on the correct antibiotics. Unfortunately, there are some primary care providers who refuse to do this because they were not the ones that ordered the test. The PVRN must then explain to the primary care physician that they are responsible for the patient’s overall health and should be the ones to address the issue. The PVRN must also explain that it is often not possible for the doctor who ordered the test to follow up with the patient due to the differing schedules of the ED doctors. This means that if the PVRN were to get the new orders from an ED doctor, it would likely be one that has never seen the patient. Therefore, in order to ensure the best quality of care for the patient, the primary physician should arrange the treatment. If the primary care physician still refuses to take action, then the PVRN must inform the ED Medical Director of the situation so that it can be
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.
Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered nurse standards for practice. According to standard 1.4 the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified in this condition. Furthermore, the nurse failed to effectively respond to a deteriorating
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...
patient history is neglected resulting to a serious health crisis or ever death and lawsuits.
-This is a highly inappropriate delegation. A unit manager has no nursing training and has no nursing license either. The charge nurse should take the report himself, ask a second nurse to do so or call back and get the report after walk-in rounds.
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
I would let them know that the Internet is a source of valuable information and to utilize it to locate additional supporting documentation. There are websites available where the clients can enter their diagnosis and procedure code to determine medical necessity.
The factors that lead to the “collapse” of civilizations are almost directly related to those that created it. Archaeologists characterize collapse by a number of elements, some of which we have evidence for, others we do not. Most archaeologists are unsure of exactly what caused the decline of most civilizations in the ancient world, yet there are many clues to some of the events that could have contributed. The collapse of the ancient Roman Empire, the Mesoamerican Mayan, and the Egyptian cultures will be discussed in the following paragraphs, with a focus on the uniqueness of each.