I was with a 71-year-old male patient in an emergency room (ER) at a community hospital. The patient had been hit by a car while on his bike. In the accident, the pt had slid on the hood of the car and then across the asphalt, so he had abrasions down his right side. However, miraculously, the patient had no broken bones and he was alert, oriented, and ambulating. During the visit to the hospital, a nurse brought in a vaccination vial and a syringe and started drawing up the vaccine while stating, “Have you had a tetanus vaccine? You need this shot. I noticed you haven’t had one recently.” The patient said “no, no, no shots. I don’t want that.” The nurse then attempted to use humor stating “it’s no big deal, it’s just a little pinch.” This comment towards an older gentleman, who knows what a shot feels like seemed condescending to me. The patient said, “no, thanks.” The nurse then said “ok, it’s your right to refuse” and left. I was dismayed and critical of the interaction and made a mental note to handle things differently should I encounter similar circumstances in the …show more content…
First, she had premature focus when she entered the room and started drawing up the vaccine before she talked to the patient about it and why he should receive it. Her non-verbal behavior was not conducive to a collaborative relationship and her distraction while asking the question and lack of eye contact was not contributive to a building rapport. The registered nurse (RN) should have entered without the vial and syringe, sat down at eye level with the patient and asked an open-ended question such as, “can you tell me what you know about tetanus?” This would have provided structure for a discussion and conveyed that the patient’s health care is a collaborative effort. It also would have let the nurse know whether the patient understood the ramifications of his decision when she did ask for his permission to give the
For example, before the doctor administered the unnecessary spinal tap, that was a perfect opportunity to teach her patient in regards to the disease process of syphilis and the purpose of the spinal tab. Although it is important to use simple language and avoid medical jargon, it is important to inform the patient using the correct names and not made up names like “bad blood” or “back shot” in an attempt to decrease the severity of the situation at hand. She should always keep in mind that she is the patient advocate, and her role as a nurse is to do what will result in the best interest of her patient. In addition, I would tell Nurse Evers that instead of telling her patients that they have “bad blood” they would have benefited from an explanation of what is Syphilis in a short uncomplicated manner. I would tell her that although she had good intentions, this is not how we advocate for our patients and provide care that results in the best outcome. As their nurse, she had the moral obligation to educate her patients on what is syphilis, the disease process, and currently available treatment, the purpose of the study and how the study would have helped the
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
Although I respect and trust nurses and doctors, I always carefully observe what is being done with myself or my family members. After watching Josie’s story and being in the process of becoming a medical assistant, I feel this story has given me an initiative to ensure patients and their families are kept safe. The generation we live in is technological, there are many resources for patients and families to utilize to educate themselves when it comes to medical conditions. Some people like to self-diagnose and it makes it harder for doctors and healthcare workers to work with those patients. This is when communication and active listening becomes especially important to work through what is fact and what is misplaced
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
“Vaccinations are causing a major upsurge in childhood diseases, adult maladies, and even deadly ailments such as Gulf War Syndrome and Lou Gehrig’s disease” (Blaylock). Every now and then an individual’s doctor calls telling them about the latest vaccine they should receive. The person immediately schedules a time to come in and get it done. But do they even give a second thought about it? Have they ever thought that maybe they do not need another vaccination? Many people have not taken the time to seriously think about the process of immunization. The truth is, there are many dangers that the average person should be unaware of. Rarely do vaccines actually accomplish what the public has been told. In fact, a lot of vaccines contain harmful substances that have been linked to disorders such as autism. The lack of education and dishonesty from doctors are putting people in danger of health problems without even realizing. Many parents feel obligated for their children to get vaccinated because of school, not knowing they have the alternative option of refusing immunization.
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 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
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...
I would like to describe my resent experience with the nurse. I visited the clinic to assess my health and immunity status. I needed to get referrals for blood tests and immunization. She invited me in. The nurse asked me for my preferred name to be addressed. She made sure that she and I were sitting at the same level. The nurse was making direct eye contact with me during whole conversation. She maintained my personal space. The nurse was actively involving me into communication. She was encouraging me to ask questions and was ready to provide needed information. She was making sure that I fully understood all nuances of the conversation when she realized that English was not my first language. She was avoiding the use of medical jargon to make the conversation easier to understand. The nurse was speaking in a soft, unhurried voice that expressed genuine interest. It was inviting for me to join the conversation. The nurse was very polite, respectful and caring. I obtained all necessary referrals for blood tests and immunization armed with all relevant information regarding it. This interaction made me feel impo...
The patient is a female in her early twenties who came in the hospital due to sickle cell crisis. She was in grave pain especially in the joints. Her hemoglobin level was low so the Physician ordered 2 bags of packed red blood cells and pain meds Q4hrs. The patient explained many times that the dose the physician ordered was not sufficient and that she needed more help. The nurse promised to contact the physician and to inform her of the response. The fact is she never did and was called urgently hours after to calm her patient who was crying in agony and wanted to go home to be in pain. She screamed out that no one cared. Some nurses were even callus enough to say if she wanted to leave then hand her the relevant document and allow her to go.
Tetanus is a bacteria that causes very rare fatal disease that people sometimes called lockjaw, they call it lockjaw because it is a tightness in the jaw. Not many people know what Tetanus is because it is so rare. The bacteria that Tetanus comes from is very good at duplicating itself; also, Tetanus has many layers to protect themselves which makes it hard to cure when you get it. You can cure it by washing out the cut right when you get it or getting it vaccinated.
At the same time of this occurrence there were other things that went on pertaining to transference and counter transference. The Intern and I definitely had some type of strong transference and counter transference going on. There was a clash of personalities between the intern and me. We totally did not get along. I felt uneasy and that she did not want me there in the room with her. Why? I thought that maybe she felt challenged. I don’t know, but I felt I asked the patient questions that she forgot to ask. I also gave her my opinion about treatment principle, which I do not think she appreciated. With my previous interns, I was very much part of the intake and treatment process. The interns and I would ask questions. If one forgo...
I introduced myself to the patient stating that I was a student nurse and gained verbal consent to carry on with the assessment, as a student nurse you must respect patients wishes at all times, if t...
Students everywhere with medical disabilities are being put at a serious risk for deadly diseases due to the lack of vaccinated students. From religious to social reasoning, thousands of parents across the United States are moving towards the "no vaccination" movement, and sending their children to public schools without proper vaccinations. As it stands now, students with either medical or religious reasons can be exempted from the required vaccinations in all states except for Mississippi and West Virginia; however, parents are taking advantage of this policy. All students in public school systems should be required to get all of their vaccinations, unless there is a medical circumstance preventing that, in order to decrease the risk of infection for all public schools.
Despite the frequency of verbal interactions, miscommunication of patient information occurs that can lead to patient safety issues. . . . ‘Effective communication occurs when the expertise, skills, and unique perspectives of both nurses and physicians are integrated, resulting in an improvement in the quality of patient care’ (Lindeke & Sieckert, 200...