Floor Nurse Strengths And Weaknesses

Strengths shown by the floor nurse include her assessment skills, and listening to the patient. Patients know their bodies better than anyone, if they report they feel like there is something wrong the healthcare provider should take them seriously and investigate the situation. The nurse was able to request an initial bedside evaluation from the attending. After evaluating the patient the attending physician made no management changes and verbalized his intention to return in an hour. The nurse showed weakness at this point when she did not agree with the attending physician’s decision, but did not voice her concerns. The nurse was not able to trust her gut feeling and/or her clinical expertise by verbalizing concern over the attending decision
to return in an hour. If the floor nurse was uncomfortable voicing her misgivings to the attending, she should have contacted the charge nurse for guidance and support. The floor nurse correctly stayed at the bedside to closely monitor, administering fluids and oxygen, repositioning, and encouraging rest along with pushing at appropriate times. The floor nurse did show strength in her decision to call the attending for a reevaluation after only thirty minutes. She eventually managed to express a real sense of urgency when they reached the operating room and she felt the resident was not aware of the impending need to move quickly towards birth. Unfortunately, by the time the floor nurse decided to convey a sense of urgent concern, it was too late and she had no idea where the attending physician was.
The charge nurse strengths were her ability to manage a very busy unit with several high acuity patients. She was able to monitor the fetal heart rate tracings enough to notice the rate was worsening. It is a strength to trust the care team is handling the situation, but it is a weakness not to verify that the care team was on ‘the same page’ when it came to the care that was being provided. The charge nurse was able to enter the operating room, take responsibility, and page the attending to facilitate the birth. In retrospect, both nurses were able to identify a moment on the fetal monitoring in which they grew concerned. Although in hindsight, the ability to debrief and recognize where critical decisions should have been different should be considered a strength.
The attending physician was timely with their bedside evaluation. To strengthen the interaction and promote safety the attending should have ensured the floor nurse was in agreement with his or her evaluation of the situation. They should have questioned whether the floor nurse had further concerns or felt the plan of care was appropriate. The attending should have actively listened to the floor nurses concerns. Their lack of communication skills and ability to care for the patient as a team added to the adverse outcome. The attending disappearing in route to the operating room affirms their inability to function as a team member and provides further evidence of their poor communication skills.