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Hello Mellissa,
I really don't like doing this, but I believe this case warrant me to inform you about a minor incident that took place on saturday night at about 0430. Alvin requested my assistance at emergency department with a coding patient arriving via ems. However, upon the conclusion of the code, a Nurse named Olivia Wilson approached me with vnasty attitude (yelling) saying her patient was suppose to be CT scan long time ago. First of all, I wasn't aware of the CT scan, the only reason I was down there in the ED was to assist Alvin with the code, and Olivia just assumed that I was aware of the CT scan. When I was exiting with Mellissa (who came to join us toward the end of the code) the ED to continue my work work in the ICU, Olivia
came after me yelling/screaming that I am refusing to take her patient to CT scan, and Alvin got involve in conversation due the fact he heard Olivia screaming at me from the down the all way.
Cynthia Adae was taken to Clinton Memorial Hospital on June 28, 2006. She was taken to the hospital with back and chest pain. A doctor concluded that she was at high risk for acute coronary syndrome. She was transferred to the Clinton Memorial hospital emergency room. She reported to have pain for two or three weeks and that the pain started in her back or her chest. The pain sometimes increased with heavy breathing and sometimes radiated down her left arm. Cynthia said she had a high fever of 103 to 104 degrees. When she was in the emergency room her temperature was 99.3, she had a heart rate of 140, but her blood
Nurses are required to protect and support their patients if they are to be an efficient patient advocate. Ethically questionable situations are quite common for nurses that conflict with their professionals and personal morals. At times, the patient necessitates the nurse to speak out for them demonstrating
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.
Section 5.4, which is the preservation of integrity, suggests that nurses will inevitably have to deal with threats to their moral or professional integrity at some point in their careers. Nurses should do their best to maintain professional integrity when met with adversity, weather it be from uncooperative issuance companies, an unsound work environment, or from the patients themselves. When working in an unsound or unsafe work environment that violates law or the ANA code of ethics nurses must go through the proper channels to fix the problem. If a nurse feels that a procedure or treatment their patient is having conflicts with his or her own moral integrity and they cannot participate, the nurse must report they unwilling to tr...
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.
Within the scenario, there was a lack of communication between the resident and nurse. There were no established principles for communication on the unit. Nurses could write on a bulletin board if they had a non-urgent matter to discuss with the doctors. The other method for communicating with doctors was to directly page them. Interprofessional rounds occur only once a week which does not account for the communication required between the doctor and nurse on a daily basis. There were no other formal communication methods for when doctors can speak to nurses. Nurses hear from doctors if they happened by chance to have seen the doctor, by word of mouth from other members, or from orders. The resident in the scenario did not seek out the nurse for second opinions and did not let her know about discharge plans. Thus, there was a lack of communication about care
I have come to fully understand that in order to treat my patients in a way that is person centred, I have to treat each person as an individual and realise that every individual has different needs and different rights and preferences to me which may go against my morals and beliefs but I always have to maintain my professional boundaries and treat each individual with respect and dignity. If I was a nurse who witnessed a similar situation to Kat’s, where another healthcare professional was disregarding my patient or any patients views or requests I would go into the patient’s room and find out what the problem was. Then I would politely ask the healthcare professional to step outside of the room and I would gently remind them of the code of ethics ((Kozier, Erb's & Berman, 2010, p.97) and the Registered Nurses standards of practise (2016), and how every individual has the right to make their own independent decisions about their healthcare needs/goals based on their own values, morals and beliefs. I would further explain that the patients are our main priority and it is our responsibility as nurses’ to ensure that the patients are safe and are receiving the proper care. I would then explain to the patient what was happening and apologise to them about the situation, and I would rearrange and try to negotiate with the patient when the procedure could be performed. Then I would notify the Nurse Unit Manager on the ward to ensure that situations like this do not occur
A traveling nurse is taking care of four patients on med surg floor at the hospital during a Monday morning shift. She is a new nurse who just started working in this facility a few months ago. This one patient is having continuous IV medication from a piggy-bag medication and the nurse is supposed to change the bag regarding the physician’s order. When the nurse comes into the room, she finds out that the previous medication bag is still full and the medication has not been administered into the patient. After assessing the patient’s condition and double-checking the medication, she hangs the new piggy-bag on the IV pole. There is no incident report filled and no-one is informed about this incident. The nurse claims that the patient’s condition is stab...
A 25 year old, male patient with cerebral palsy and poor motor control is admitted through the ER. He is complaining of severe abdominal pain, vomiting, and increased fatigue. Due to frequent hospitalizations in the past, he is well known to the team on the floor he is being admitted to. The RN admitting the patient, tells the ER nurse calling in report that she is very familiar with him and really doesn't need a a whole lot of details in her report. After admission to the floor, the patient continues to complain of pain and vomits a small amount of coffee ground emesis. After a physical assessment,
Every Wednesday I was assigned a patient to attend to by a specific nurse who was also my supervisor in a hospital setting. My instructor ensured that this nurse followed my progress in respect to the way I was to handle the patient through written report. While taking care of the patient, I recorded various changes, he/she indicates towards recovery. I reported these changes to the nurse. While participating in this activity, I was expected to follow the strict guidelines by the instructor and nurse; as required by the rules and regulations, and code of conduct in nursing.
I escorted her to a room, and helped her change into a gown. I understand that a 22-year old is capable of changing her own clothes, but I wanted to spend more time with her for further investigation. Auscultation of the lungs revealed bilateral clear and equal breath sounds, and heart tones were audible and regular. No peripheral edema was noted upon examination of her lower extremities, and she denied a history of similar symptoms or any medical issues in the past. Again, my nursing experience was challenged. Everything looked great, except this feeling remained that something was wrong. ER was busy that day, so I put in on order for a chest x-ray, and then told the doctor why she wanted to be seen. I told him that I ordered an x-ray, but something was not right about her skin color, not jaundiced, swallow, or cyanotic just not right, and I asked for basic lab work. The doctor felt lab work was not needed at that time, and I did not push the issue. I just thought to myself, “maybe he is right, and I have worked too many days in a row”. When the patient returned from the x-ray department, I met her at the room. I asked how
From this situation, I will still preserve my quick acting assertively with my colleges to ensure that the nurse washed hand before entering resident’s room. My silent can put resident’s health at risk. I should have a positive attitude toward the nurse and talking to her about the mistake she made in her practice. As a student nurse I should understand the pressure nurse having at the time and do safe practice.
This patient was so sick, even at 7:30 pm when I completed my initial assessment that she was not able to pick up a glass of water by herself. Overt the course of a mere 2 hours this patient was crashing, requiring additional IV access sites and transfer to an ICU room to later be transferred to a different hospital. I ended up talking nursing supervisor on duty about the situation and was assured that the off going nurse would be talked with about the in appropriate room placement of the patient to prevent a similar scenario in the future. As a nurse, I fully believe that we are there to be our patients advocates. We are there to support and protect them in whatever way that we can. While I cannot fully attest to the resolution to this dilemma, the nurse later apologized for the way that she cared for this patient to the family
I had an elderly patient that was admitted with broken heart syndrome, due to her husband of sixty years passing the recent month. The family of this patient wanted to fly her to a different state to be close to family; with her husband passing she no longer had family here to help her. This patient’s health started to decline during her admission to the hospital and she was found to have possible gall stones and cholecystitis. On the last evening that I had her she was in a great amount of pain and was getting agitated and restless; due to this the family requested that I give her Ativan, with her NPO status I had to give the Ativan through IM injection. Through the night she declined progressively and went unresponsive, I made multiple phone calls to the physicians and to our rapid response nurses in hopes that I could help her in some way; they all kept telling me that she was unresponsive due to the Ativan and to give it time to wear off. After morning labs were drawn I was called with a critical WBC count of 38 that was up from 11 the day before, I followed protocol and called the physician on call and was told she was already on antibiotics and there was nothing else we could do. At the end of my shift I gave report to the oncoming nurse and left and thought about this patient all day. I found out later that this patient was sent to the ICU that day and later passed away that week. For me this was a very difficult situation, I assessed and reassessed, I advocated, and gave care to the best of my abilities but no one wanted to listen to me that this patient was deteriorating quickly and in the end she died from it. Now I try to look at this as her getting to go be with her husband, but this could have gone a completely different way. Although we follow our scope of practice as a nurse we may not always get the end results that we hope for,