Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
Need for professional ethics
Need for professional ethics
Ethical issues for healthcare professionals
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Clinical Narrative 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,
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
On May 20th, the patient, Mr. Ard, experienced nausea, shortness of breath, and pain while being treated in the hospital (Pozgar, 2014). The patient’s wife, Mrs. Ard, attempted many times to reach a nurse by pressing the nurse call button (Pozgar, 2014). Once the nurse finally responded, anti-nausea medication was administered (Pozgar, 2014). Mrs. Ard continued to monitor her husband’s situation, and felt as if the nausea and shortness of breath were getting worse (Pozgar, 2014). Mrs. Ard continued to ring the nurse call button for approximately 1.25 hours prior to a response from a nurse (Pozgar, 2014). A code was called, and Mr. Ard did not survive (Pozgar, 2014).
Conclusion: The whole event made me realise that maintaining once dignity and respect can make a lot of difference in patient life. It gave me great insight into bowel cancer and terminal ill patients and their care. I will research more and learn more to better myself and make difference in patient life by simply maintaining dignity and respect that is key in any health care setting .This incident made me respect the profession more and value the person I was looking after and boost their self –esteem, and learnt that working in the community with the relatives around watching was challenging.
Tabitha walked onto the medical-surgical unit and received report on five patients in a record ten minutes before she began her busy shift Tuesday morning. The off going nurse managed to talk about the pet peeves and subjectives of each patient but was in a rush to make it to the monthly nursing practice council meeting and ‘everyone is doing fine’. Tabitha was unaware of the potential chaos that would ensue as her day progressed. As Tabitha walked into her patients’ rooms that morning to introduce herself, little did she know that Mrs. Jones is a high fall risk with no signage or alarms plugged in; Mr. Hill has fluids infusing at one hundred and fifty milliliters per hour with a history of congestive heart failure (CHF); and another patient is scheduled for surgery with no pre-operative paperwork or consents completed.
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.
Patients have long lamented that their doctors do not truly listen to them. A new emerging discipline, Narrative Medicine, seeks to rectify this problem by teaching both medical students and doctors alike the value of empathy and through the use of literature how to listen, dissect, and reconstruct patient’s narratives. Although Rebecca Elizabeth Garden and Rita Charon, agree on many aspects of Narrative Medicine, Garden tends be more critical and points out more flaws in her work entitled “The Problem of Empathy: Medicine and the Humanities,” whereas Charon cites the numerous benefits of Narrative Medicine in “Narrative Medicine: Honoring the Stories of Illness.” Although Narrative Medicine is beneficial because it allows doctors to develop empathy, one should also realize the many potential pitfalls and complications that arises.
During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the past following the same problems. This particular patient was in her room, isolated in a corner, and she was irritable. As her student nurse, I was actively involved in her care; I was her advocate for the day. The patient lived with her single mother and worked at a fast food restaurant. Since this was my first time dealing with a patient with DKA, it became a definite challenge for me.
All of my patients outcomes were met today. He ate the majority of his breakfast, which was being monitored. He also took all of his medications, nasal sprays, and inhaler. The Patient was determined fit to go home and was to be discharged today. So I removed the patients IV, and helped secure his ankle bag for him before he was to start getting ready to pack up for home.
This story shows what happens when there is a break down in multiple areas of health care, including communication, the nursing process, and patient advocacy. As a new nurse, this case is important to hear and to learn from. It teaches us that patient centered care means listening to the patient or the family when they say something is wrong because they know themselves and/or the patient better than the staff. Even if the cause is not obvious, there is a need to follow through with your instincts or gut feeling when something doesn't seem right. A personal example that I recently had to learn from was when a resident was not as active as she had been. I was told in shift report that she had a weight gain. I wanted to send her to the hospital, but a more experienced nursing supervisor told me it was unnecessary and that the doctor would be in the following day to see her. She was seen the following day and there were no new orders for her. I ignored the feeling that something was not right with her because the doctor had cleared her. With in a week, she was sent out to the hospital and diagnosed with a CVA and CHF and returned to us with a new status as a DNR and put on hospice. From this I learned that it does not matter how much experience others may have, I need to trust in myself and my judgment. Since this event, I made the decision to send out one of my residents
Narrative Therapy (NT) is a post-modern approach to Family Therapy (FT), derived from French post-structuralist theory, in particular Foucault’s concepts on dominant and subjugated discourses. This represents a major departure from more traditional FT models (i.e. Structural Therapy, Strategic Therapy, Transgenerational FT etc.) which, due to their overtly modern worldview, frames familial interactions as mechanistic processes and prescribes correspondingly rigid interventions.
We read personal narratives in order to relate to other’s experiences and place ourselves in other’s to relate to their conflicts or learn about conflicts that we have yet to face. Reading about a similar experience helps us increase our sense of connection to others. Reading about an experience we haven’t encountered will better prepare us to face new challenges or help other people face them. In order to do these things, outstanding personal narratives should place the reader in the narrator’s shoes so the reader could understand everything the narrator went through in their experience. The most powerful personal narratives effectively deliver these benefits when they use imagery that connects us to the narrator’s emotional experience, have
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
I was caring for a patient that was diagnosed with congestive heart failure. After receiving bedside report, I preceded to my patients charts for morning labs and such prior to beginning my patients assessments. Upon entering the room of said patient, I began my assessment and realized that the patient didn’t seem the same as a few minutes ago when receiving bedside report. When I asked how the patient felt, she explained that she wasn’t feeling well and felt a little nauseated. I just didn’t feel right with my patient’s condition so I called the rapid response team to assist with this patient. During the rapid response, I stayed with the patient the entire time to provide safety and emotional support. I administered medications as needed throughout the process. The patient was transferred to the intensive care unit for further observation. I charted what had happened and the outcome of the situation. It was through my knowledge, nursing judgement, and skill that I was able to process this situation through the nurse’s scope of
Narrative Therapy was developed to help people separate themselves from their problems. The idea is that this will help the person use the skills that they already possess to minimize the problems that exist in their everyday lives. The Narrative Therapy approach was developed by Social Workers Michael White (Australia) and David Epston (New Zealand) during the 1970s-1980s. “White proclaimed is work to be exclusively that of ‘rich story development’ “(Gallant).
Narrative therapy (NT) is a therapeutic technique that guides the client through a process of identifying and deconstructing the narratives they hold true, and reconstructing or re-authoring (Epston & White, 1990) new and empowering narratives. It is based on the idea that people understand their lives through their narration of lived experience (DiLollo, Neimeyer & Manning, 2002). “As narrators, the significance of our lives is dictated by the stories that we live and that we tell — that is, by the ways that we link events in meaningful sequences and thereby constitute a sense of self as the protagonist of our own autobiography” (Neimeyer, 1995). Narrative therapists tend to look for metaphors that have powerful connotations in a person’s