Karen is a post visit register nurse (PVRN) at Cincinnati Children’s Medical Center (CCMC). She has been an employee at CCMC for nine years but has only had this position for about four years. PVRN’s are responsible for following up on any positive culture results to make sure the patient is on an appropriate treatment plan. If they are not receiving the correct treatment, the PVRN must contact the doctor to get orders for the necessary medications and educate the family of the updated treatment plan. PVRNs also make follow up calls to patients who have been seen in the Emergency Department (ED) within the last 24 hours. During these calls, they make sure the discharge plan has been implemented and any follow up care is arranged. The …show more content…
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
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
Planning included reaching out to other health organizations, objectives, and goals of health fair were established. The implementation includes getting volunteers, set up for the health fair. The evaluation of the process occurred throughout the implementation and changes were made as needed. The evaluation will be completed by gathering information from health booth to determine the number of participants. Review vendor and participant evaluations about the health fair including how they heard about the health fair, ratings of booths and suggestions for improvements. Record everything to determine changes. Reflection on past experiences and what worked and did not work.
Through centuries nurses were given the title “Caregivers”. Unlike some doctors, nurses actually care for their patients, not necessarily saying doctors do not; they both just have a different way of caring. Yes, doctors cure illnesses, but nurses are just as important because they help with the healing process. Most nurses can have the same exact education or knowledge as a medical physician but the only thing individuals see is a name tag with either the acronym CNA, LPN, R.N. and PH.D. Of course PH.D will get all the credit, seeing as how nurses do not exactly diagnose patients. A nurse could just become a doctor but there are different aspects of each title. Nurses take instructions from a higher administrator, which is sometimes a doctor. What needs to be known is doctors are not the only ones that stress and have rules to abide by. Nurses have ethical codes, daily ethical dilemmas, morals, and ridiculous distress, but some of these examples differ with country, state, and hospital. If nurses are capable, then they should be given the opportunity to make medical decisions or diagnosis in critical situations.
She should have not made the assumption that there were no doctors available until 2100 hours. Instead, she should have sought clarifications on whether the Emergency Department (ED) doctor was prevailed on examining the patient. She should’ve escalated concerns to the Clinical Nurse Manager (CNM). She also should’ve not made the assumption that the administration of antibiotic would improve the patient’s condition and “recover” her from the “red zone”. Finally, she should have documented her observations and implement a care
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
As a NP in the urgent care field K.W. analyzes lab data during many visits. This competency focuses on skills, understandings and integrative abilities and this helps the APN with basic foundation in being able to translate results into the proper patient outcomes (National Organization of Nurse Practitioner Faculties, 2012).
First and foremost, nursing is not just a job. It is a profession that requires giving “self” every minute, of everyday. Though job security and salary can be added benefits, they simply could never surpass the emotional, psychological, and physical components that nursing requires. Some might think it is alarming that at the point of preceptorship, the end of a student’s career, he or she believes job security and salary are the reasons to go into this field, even worse that he or she would admit it to a seasoned nurse. In a moment like this, the preceptor will have to take a deep breath, close her eyes, and remember all the moments in her career that kept her going.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
According to Chaloner (2007) states that Ethics is about good and bad, where nurses are fully trained to provide quality care to the patient and raises the value of ethics by being medical centred and having emotional impact in treatment and sometimes the patient refuses nursing care resulting as bad (p22-46). To relate ethics successfully, nurse’s thinking abilities and beliefs that support ethical enquiry such as autonomy, non-maleficence and beneficence makes care plan on ways for decision making in patient care. Example, the moral values which we gain from childhood like honesty, mutual trust, respecting, and treating others fairly are used in having therapeutic nurse to client relationship.
Friendships may be formed; however, having professional interactions is something that is not always followed. In terms of patient confidentiality, we may not realize that a HIPPA violation has occurred due to a friendly conversation with coworkers. If a patient were to overhear their nurse discussing their information in an unprofessional manner, then it may cause issues with a patient’s dignity and their rights. If a patient’s right is violated, then it can lead to a patient’s mistrust in their caregiver, leading to mistrust in the facilities, and can end with a patient’s health being compromised. The patient is the reason for this career; if the needs of the patient are being unmet or violated then the purpose of our occupation will be unsuccessful and indifferent.
Ethics asses the values, morals, and principles of nurses. Legal codes or laws are rules established by our government. It’s important that nurses have a clear and comprehensive understanding of ethical and legal codes within their career. The understanding of these codes is essential for nurses to safely practice and to protect their patients. Nurses must abide by these principles or face the consequences of legal action. These principles include autonomy, utilitarianism, confidentiality, and many others. Autonomy is the agreement to respect ones right to determine a course of action, while utilitarianism is what is best for most people as defined in American Nurses Association. In order to give you a
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
Ethics is defined as moral principles that govern a persons or a group’s behavior, ethical principles apply to both personal and professional relationships (Webster, 2015). The field of nursing is a profession that has been highly regarded and respected in society. Most nurses enter the profession in order to utilize their clinical skills to help others in their time of need. Those in failing health rely on nurses to care for them in their most vulnerable states, and expect a level of compassion and humanity while receiving care. Nurses have an ethical responsibility to their patients, clients, and their community. Compassion, empathy, and integrity are staple characteristics that nurses possess that allow them to successfully perform their
...s expressed by most treating physicians if best treatment is not possible. Most of those wound are sadly sent to a community nurse for dressing change without the patient coming back to the treating physician for assessment of "maintenance wound" treatment.