Ms. Mason-Hagler's post brings up a very important topic about many doctors being nescient or apathetic to the limitations of subordinate staff. I have witnessed surgeons on occasion tell nurses and technicians to perform duties outside of their scope of practice for the simple convenience of saving time and the physician not having to do it themselves. A timorous nurse may find it difficult to confront a physician's orders since they are in a position of authority. However, nurses and subordinate staff have due diligence to the health and safety of the patient before a physician's order or hospital guidelines, policies and procedures. The six-step decision-making model is a beneficial tool for all nurses to follow whenever performing new or
unfamiliar skill sets. Mr. Capucetti's post describes precisely the purpose for establishing standards of care. However, there is no exact measure of what the standard of care is. What one reasonable and prudent nurse may consider a justifiable practice today may be considered questionable or flagrantly wrong by other nurses tomorrow. As nurses, we are obligated to maintain an ever-changing higher standard of care. Older nurses who have many years of experience may not be as compliant and/or up-to-date as a younger, reasonable, and prudent nurse. For example, I have seen older nurses and respiratory therapists flush a patient's endotracheal tube with five to ten milliliters of normal saline and then suck out a small portion of the flush. This practice can potentially seed bacteria further down the respiratory tract, thus causing harm to the patient. Some older nurses may find the practice acceptable, while many current practitioners consider the practice unsafe.
Making a clinical decision is a skill that needs to be acquired, and nurses are accountable for any decision that is made, so they need to understand how they make decisions (Nursing and Midwifery Council (NMC), 2015). A greater understanding of how nurses make decision is essential to follow research and development of decision making skills (Clark et al, 2009) . A first step to a decision making process may entail understanding a framework or model. Baumann and Deber (1986) define decision making as situations in which a choice is made among a number of possible alternatives often involving values given to different outcomes”.
...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.
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
When everyone is working on the patient making progress in different directions, the patient will be completely lost and eventually lose confident in the caretakers. Atul Gawande describes this through a car analogy in which a vehicle is made using the best features of different manufactures. He describes the care as, “A very expensive pile of junk that does not go anywhere… It’s not a system.” Everyone has a different skill set that if used in a collaborative way the medical team will be able to identify the problem more efficiently, recognize areas of failure and address them in a timely manner, and lastly with an ordered system the patient-physician relationship will form a stronger bond. With a more ordered work environment, the health care professionals will be able to attend to the patient more keeping them informed and be able to interact with the physician more frequently. Just to show how well this order work Gawande noticed that with an implemented checklist complication rates fell 35 percent and the death rates decrease 47 percent far more than any drug. This will allow the physician and nurses to not only help the patient with physical treatments such as medicine but psychologically as
For hundreds of years doctors and other medical professionals have gotten away with little to no punishment when doing wrong in the medical field. Medical Malpractice happens in the care of the reckless medical professional and can be stopped by the correct supervision and discipline. Although medical malpractice is something huge, it could be eliminated by just taking a little extra time and review the care that is being given to a patient. Would you allow someone to give the care you’re giving to others, to your own family? You need the bed, so you discharge early. Patients aren’t properly informed. Legal documents aren’t thoroughly explained. Shortage of staff, hospital downsizing, or mergers. (“Nursing Center”) The only thing that the medical team should be worried about it the care of all of the patients. The medical field would become more advanced if the actual medicine was practiced the right way. Lives are being compromised everyday with incompetent doctors, practicing medicine. Medical Malpractice can be solved with the buckling down of the medical professionals, and the administration that watch over these professionals. Medicine is a complicated field, where lives, money, and careers are put on the line for such an important matter. Together, we can lessen, even eliminate Medical Malpractice all
A nurse’s role in decision making is minimal depending on the place of work residence. Authors Shoni Davis, Vivian Schrader, and Marcia J. Belcheir’s opinion on Ethical decision making in nursing is “a process that involves making an ethical consideration of a patient care situation” (738-749). It seems like nurses can just cite immediately or take a hunch of what is wrong with a patient, but doctors are the ones that actually do the direct diagnosing. There have been many decision making processes and theories. Each has its own unique concepts and terminology, but all have similar components. It identifies good nur...
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.
This paper explores the legal, ethical and moral issues of three healthcare colleagues by applying the D-E-C-I-D-E model as a foundation of decision making as found in Thompson, Melia, and Boyd (2006). Issues explored will be those of the actions of registered nurse (RN) John, his fiancé and also registered nurse (RN) Jane and the Director of Nursing (DON) Ms Day. Specific areas for discussion include the five moral frameworks, autonomy, beneficence, Non – maleficence, justice and veracity in relation with each person involved as supported by Arnold and Boggs (2013) and McPherson (2011). An identification and review of the breached code of ethics and the breached code of conduct in reference with the Nursing, Council, and Federation (2008) will be addressed. Lastly a brief discussion on how the three schools of thought deontology, teleology and virtue had effects on each colleague (McPherson, 2011) .
The healthcare system is very complex, and the nurses should be aware of all the policies, laws, ethics, and available sources to provide quality care to all patients. The following case study will explore some of the decision-making processes the nurses consider while caring for their patients to keep high standards of care.
In order for this policy to be properly implemented in a medical-surgical unit, the hospital must be in agreement to this evidence-based proposal. The nurses are responsible to abide by this policy, complete the MSAAT during their shift and document their findings on their computer system. The nurse managers are responsible in ensuring that the MSAAT criteria are met and that the scores are accurate by conducting regular patient reviews and nurse
The intervention refers to the treatment provided to the population of the study (Riva et all 2012). In this case, the intervention is the suggested compliance of the entire WHO Surgical Safety Checklist versus noncompliance or lack of completing the full checklist. Full surgical team compliance of the checklist provides safety for patients undergoing surgical procedures, appropriate team communication, and beneficial results for patients and staff. It would be advantageous, especially in emergency situations, to implement an assigned RN to be responsible for the checklist to minimize the risk of any mistakes made by the operative staff. Regardless of the severity of the emergency situation, the checklist should be evaluated in order to prevent any further complications or mistakes and to provide accurate team
As a nurse in the medical field for the past ten years, I have learned the differences in my scope of practice in providing care and facility policies. An experience I encountered, was a patient requiring a procedure that I hadn’t been trained on. This situation left me to figure out what I was legally able to do, questioning if I should speak up, and examining if by doing this if it would directly affect my job or having any lasting repercussions.
I feel as if the patient’s are our number one priority. They come to us for help, and we should be there for them and advocate their wishes. The code of ethics was put in place partially for this reason, to make sure our patient’s have top of the line care. When a patient comes in and states they are in pain, they should be treated as if they are in pain. If a patient declines a medication due to the route and location, then the nurse and physician should work together to form another option. A patient should never be sent away without being treated first. One recommendation I would make is to form an algorithm for pain treatments, just as they do for cardiac arrest. That way when a patient comes in and declines the first option, there is a protocol in place that includes other options. I would also recommend transferring the patient to another unit to be treated if fast track does not have the resources. The patient should also be informed of the treatment right away before making them sit and wait for
Define the three primary types of decision-making systems, and explain how a customer of Actionly might use them to find business intelligence.
The medical community has changed since the 1980s, as positions and duties has changed. Each position contains specific duties to help with patient care and outcome. Just like a pyramid, each position holds a superior rank to the other. The doctors are at the peak and control the patient care. They make the decisions based on the information provided to them by the nurses. The registered nurse (RN) is at the next level and communicates between the doctors and the supporting staff. The supporting staff, the final level, assist the patients on a one on one basis. This pyramid of positions alters depending on the specialty or facility that an individual is employed, and condition of the patient. One without the other is an impossible task...