The Lewis Blackman Story is a monologue by Helen Haskell that tells the story of the tragic death of her son Lewis Blackman at the age of 15 in the year 2000 (Acquaviva 2013). Lewis Blackman was admitted to the hospital for a new procedure to correct his pectus excavatum. This procedure was new and was suppose to be safer than the older alternative surgery. Lewis Blackman’s mother, Helen Haskell states that the drug used to control her son's pain following the procedure was Tordol, which she feels, along with the dismissal of his condition in the days following his surgery, lead to the death of her son (Acquaviva 2013). As a nurse, one of the many important concepts taught is the importance of effective and therapeutic, two way communication. …show more content…
Two way communication meaning that not only are the nurses communicating to the patients and family, but also hearing what is being communicated by the family and patients. The Lewis Blackman Story is a prime example of a break down of communication and the horrible consequences of that breakdown. Had the staff listened to Helen Haskell and used critical thinking, the outcome may have been completely different. It is hard to imagine when listening to her story that such blatantly obvious signs of his decline could be missed. However, in an article by Kimberly Acquaviva, PHD, MSW and co-authored by Helen Haskell (2013) , they explore the idea of “anchoring” in which the health care workers hang onto a preconceived notion, in this case that this was a healthy 15 year old boy that underwent a minor procedure so there was no reason for him not to be okay. They also discuss the fact that some of his symptoms were hidden by expected symptoms such as the abdominal pains being dismissed for gas pains, because gas pains may be an expected outcome of a patient on pain medication and the more realistic reason for lack of blood pressure in a healthy teenage boy had to be equipment failure. The preconceived idea of a strong healthy boy was that he would fully recover from this surgery and they shaped the symptoms to meet this idea. When comparing and contrasting what happened in the Lewis Blackman case to what should have happened if applying the nursing conceptual framework, it is easy to see where each breakdown took place. If using the nursing conceptual framework, the patient would have been at the center of the care as well as his mother, however in the example of Lewis Blackman’s care, it was evident that the center of the care was the nurses and their preconceived idea of what his outcome should have been. Had he been the center of his care, the nurses would have had to look at him as an individual and recognized the deviation from the expected. Using the QSEN approach and nursing process, they would have needed to assess this deviation, implemented a more team driven approach to include the family, nursing staff and the physician as well as the surgeon and recognized the problem (Hood 2014). Each patient needs to be seen as an individual and not as their diagnosis.
They must have their own customized plan of care because each patient comes with their own unique set of circumstances. Symptoms should not just be taken at face value, but should rather cue one to assess the patient, and initiate the nursing process. In this case, the nurse felt the abdominal pain was gas pain. She implemented a plan of care to increase the patient's mobility in hopes to relieve the pain, but this is as far as she went in the nursing process. Had she continued with the process, she would have realized that in the evaluation stage, this patient did not meet his goal of relieving the pain and she should have then gone back to assessment, realizing that the pain may not have been gas …show more content…
pain. In the Lewis Blackman Story, we heard a story about a boy suffered an unfortunate and unnecessary death.
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
to the hospital with a suspected infection even though he was just seen by the APRN for his symptoms, even the EMTs that responded gave me a hard time asking why he couldn't just go out in the morning. That night he was sent for emergency surgery for an abdominal abscess.
At noon, while staff were having difficulty attempting to draw blood, Lewis became unresponsive. Helen called for help and Dr. Murray arrived to the room (Monk, 2002). A code was called and the on-call physician, Dr. Adamson, arrived and subsequently attempted to resuscitate Lewis for an hour before calling a time of death at 1:23pm (Kumar, 2008; Monk, 2002). An autopsy later revealed that Lewis Blackman died from internal bleeding caused by a perforated ulcer with close to three liters of blood and digestive fluid
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.
My initial response to the issues was only based on the hospital policies regarding the care of the patients within the hospital. However, when I was guided down the different paths and made to look through the different ethical lens, I found it tough to do so and seem to resort to my core values of autonomy and rationality. By putting the patients’ first, hospital policies, and then their loved ones in the first scenario, I determined that a compromise was necessary. Whereas in the second scenario, I feel as no agreement was needed just staff education (EthicsGame Simulation, 2016). In this particular case, Carlotta, the RN shift supervisor, needed further training to understand the hospital policy on who is or is not considered to be family (EthicsGame Simulation,
...., Johnson, D., & Thomas, C. M. (2009). The sbar communication technique: teaching nursing students professional communication skills. Nurse Educator, 34(4), 176-180.
When the practices in the healthcare delivery system or organization threaten the welfare of the patient, nurses should express their concern to the responsible manager or administrator, or if indicated, to an appropriate higher authority within the institution or agency or to an appropriate external authority” (3.5 protection of patient health and safety by acting on questionable practice, ANA, 2015). The example of the practice is a patient discharge from the rehab facility to the Personal care unit with pending PT/INR results, which turned out to be critical. The admitting nurse demonstrated moral courage by questioning physician who wrote discharge orders and the nurse who completed discharge. Rehab physician refused to address lab results and referred the patient to the PCP. Admitting nurse raised a concern to administration to review discharge protocol and deviation from safe practice. Nurse acted on behalf of the patient and requested readmission to rehab based on patient’s unstable medical
According to Du Pre (2013), effective health communication saves time and money, helps healthcare organizations run effectively and is an important source of personal confidence and coping ability. She approaches communication with each patient and their family through a process of understanding and sharing meaning (Du Pre, 2013, p. 8). She pays close attention to the people she is communicating with by listening and watching their actions and emotions; she encourages a sense of team – that they are not alone; she displays sensitivity while being pleasantly comical. The intake nurse is one of the first medical professionals the patient encounters while visiting the emergency department. She ultimately sets the tone and standard for health communication, and I feel that she does an excellent
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
The introduction paragraph gives information on communication and the impact that it has on patient-nurse relationships. It gives the reader an understanding of what is involved in true communication and how that it is a fundamental part of nursing and skills all nurses need. It leads those interested in delivering quality nursing to read on. Showing us the significance that communication makes in the
A week before Christmas in 2013, my stepfather suddenly lost consciousness. His body stiffened and he began to violently convulse – he was having a seizure. Later in the hospital, the doctors informed us that my stepdad had suffered a hemorrhagic stroke. The anguish that I felt that night was eased by a nurse who talked to my family about my stepfather’s condition and assured us that the hospital would do everything that they can to assist him with recovery. The next few weeks were filled with uncertainty as my stepdad laid comatose, no knowledge of when or even if he would wake up. During that time, my interactions with the nurses always made me feel safe and comforted Unfortunately, he passed away in January 2014. Though this was a traumatic and life altering experience, what I remember most are the nurses that provided care to my stepfather. They went above and beyond their outlined job duties to care for my loved one and to make my family feel secure even in such a difficult time.
“Communication is the heart of nursing… your ability to use your growing knowledge and yourself as an instrument of care and caring and compassion” (Koerner, 2010, as cited in Balzer-Riley, 2012, p. 2). The knowledge base which Koerner is referring to includes important concepts such as communication, assertiveness, responsibility and caring (Balzer-Riley, 2012). Furthermore, communication is complex. It includes communication with patients, patient families, doctors, co-workers, nurse managers and many others. Due to those concepts and the variety of people involved, barriers and issues are present. Knowing how to communicate efficiently can be difficult.
Therapeutic communication is an important skill for a nurse to utilize when it comes to relationships between the patient and nurse. In Regina’s case, integration of empathetic and compassionate communication skills in combinat...
Interpersonal communication within the field of nursing is imperative in all areas to deliver a holistic positive outcome in patient care. Specifically, active listening, questioning with intent and reflective feedback ascertain an understanding of a patient’s health, illness, and healthcare. Active listening allows the patient to convey their concerns and presents the nurse with an understanding of the patient when implementing a personalised care plan. Questioning with intent builds an appreciation of the situation, and reflective feedback promotes improvements to enrich work ethics of the nursing cohort. Listening actively involves many different styles whereby information is gathered through verbal and non-verbal communication. Questioning
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
Communication is an important concept of caring in nursing because the nurse has to know how to communicate efficiently in order to get the patient to trust the nurse enough to open up to the nurse and also the nurse needs to communicate respectfully to show the patient that they genuinely do care about their health and want to help them as much as they
The most basic of nursing education revolves around the teaching of effective and therapeutic communication