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Nurse communication skills essay
Communication & interpersonal skills in nursing
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But for me I would 50% questioned that in my brain because if it is that almost all nurses do leave medications unattended in the patient room is a problem and need to be solved to prevent the same issue from happing again. Furthermore, there were another staff issue. There was a miscommunication between two staff during shift report at the morning. a patient has asked for pain medication, so that the night shift nurse brought the medication form the pharmacy and asked the morning shift nurse to come with him to patient room to give the patient the medication and at the same time to make the report at the bedside. The morning shift was not willing to have the report at the bedside, so that she asked the night shift nurse to go and give patient
the medication and then return back to the station for shift report. The night nurse then gave the morning nurse the medication and stated that my shift has already ended and you should thank me that I brought the pain medication instead of you. I didn’t attend this issue because it has happened before I came, but the manager told me that the two nurses should solve this issue by themselves and she told them that she didn’t witness what has happened but what is important is that the patient is needing the medication. Finally, my preceptor and her assistance are working on Beacon Application for Excellent Award. This document has every things about the unit and organization. I wish I have an opportunity to read it. It includes numbers of category regarding patient safety, staff safety, quality, evidence based practice application, strategical plan and others important area.
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
To determine if the nurse was diverting narcotics, I would first want to discuss with the staff that stated that she suspected a fellow coworker of diverting and get the whole story from that nurse. I would document everything that the staff nurse told me, all subjective and objective data. Then, I would document what I saw that made me suspected the nurse as well. I would have all information about the first and second incident ready to present to either human resources or my supervisor. Then after discussing with the staff and gathering the data, I would discuss with the correct personnel about organizing a drug screen for all of my employees that were working during the shift in which the narcotics went missing. This would be to see if any of the employees had narcotics in their system, including the nurse suspected, and we would be especially aware of the type of drug that was missing (morphine, etc). I would then sit down with the staff member who was drug diverting or tested positive for the drug, to discuss consequences. I would also sit down with my staff as a whole about how to handle this type of situation in the future, the importance of reporting, the problems of using drugs and drug diversion, and debrief the staff about necessary information they needed to know about this incidence.
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
Following the QSEN model, this problem is a concern that falls under the safety category. The Institute of Medicine defines safety as, “minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (IOM, 2003). A nurse manager must address this problem because without nurses who are able to work, patients cannot be taken care of in a safe and effective way. As a nurse manager, it would be ...
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
It is not unheard of for a nurse to accidentally make a medication error by not following the five rights of medication administration; this could potentially harm a patient. If the nurse reports the mistake right away to their supervisor, regardless of the consequences and makes sure the patient is safe they are being honest and acting in the best interest of their pat...
After a long while of looking at small tools and a lack of sleep, a nurse’s eyes can be weary, just like anyone else. Nurses need rest just as much, if not more than, the rest of the general population. There are only twenty four hours in a day and if one works for a twelve hour shift it does not leave much room to enjoy family or have a social life. Because of this, nurses are often sleep deprived and they find alternative sources of escape. Some of the so called sources or coping mechanisms are medicinal. Nurses have a good knowledge of medications and their side effects, so one might think they would be confident in taking drugs they provide their patients on a regular basis; however, many nurses use that knowledge to abuse these medications. They may take some from work instead of giving their patients their full dose and may overdose on those drugs to escape the stresses of daily
For instance, if controlling the pain been an issue during the previous shift, then the going off duty nurse need to address this issue to the oncoming nurse regarding what pain medications were administered and how effective these medications were. Similarly, if the patient is using a patient-controlled pump, then the both nurses should clear the pump together. When both nurses clear the controlled pump that was used by the patient to control his or her pain during the previous shift allows the oncoming nurse to assess how much medication patient used during the previous shift and how the patient’s pain is being managed. Thus, it is important for both nurses to address any issues and plan for pain management because their priority during their shift is to keep their patient comfortable and
Working at the hospital for a little over a year now I have seen a few instances that are a "near miss", some a failure, and as of today a complete failure in patient safety but is being overlooked in some ways. Being the most recent and fresh in my mind this incident included a known drug addict, and an order that read "pt. may go outside with family". During shift report I asked the night shift RN why a known drug addict has outdoor privileges, when it is hard enough to get anyone the order to go outside. The RN giving report agreed with me, but since the ordering physician wasn 't available we could not challenge the order overnight. As my shift continued I go into the patients room to check on them and the bed was empty the wheelchair was gone and the bathroom was empty. I asked my Clinical assistant and she said that she was never told the patient was leaving (strike 1: patients need to tell staff when they leave the unit). After 30 minutes I looked in the room and the patient was still gone, after an hour the patient returned with a family member (strike 2: patients are allowed 15 minutes off the floor). I quickly went into the room and asked the patient that if they would like to leave the unit they need to notify staff before they leave and patients need to come back to
Patient safety should be the highest priority when it comes to health care, so why wouldn't the administrators reduce the ratio of nurse to patients to provide maximum patient care? Nurses that have a higher workload of patients are probably more prone to commit a medication error because they may not have the time to do the five checks of medication administration: the right drug, the right dose, the right route, the right time, and the right patient.
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
This may happen due to the nurse thinking it is the patients fault, and therefore thinking they do not deserve the same quality of care as the next person. This is not fair to the patient, as one never knows what the underlying cause is, that has led to the situation. It is really important to form a good patient nurse relationship, and to get all the facts, in order to assure this does not happen.
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
Team coordination could be the best solution to prevent such medication errors. When Lawanda was assigned a duty in the ICU to give physician ordered medications to the patient, it would be the duty of other nurses in the team to check whether the things in medication drawer are properly arranged and also to recheck the appropriate medication before handing it over to Lawanda. This lack of coordination and improperly assigned duties among team members finally lead to death of the patient. The issue clearly shows that not Lawanda alone, but it is the team that is responsible for the medication error. Balanced participation and sharing responsibilities equally among the team members to achieve the tasks would help resolve this issue (Gordon,