He is dumbfounded that this sort of situation could happen to one of his patients and blatantly blames the nurses. He questions their intelligence, asking how they did not know that the girl’s parents are divorced and only the mother has custody. The father is not allowed to take his daughter due to legal rights, and big legal issues are involved with inattentive behavior. Dr. Munoz is the number one ENT for outpatient surgeries at Nightingale and is afraid that with his neck on the line for this casualty, he will lose credibility. Surgeons are responsible for the medical operation itself, as well as making sure the patient gets from pre-operative care to surgery to post-operative care safely. In these regards, Dr. Munoz did his job, but is still unhappy with the negligence of the nursing staff. His office notes state who the custodial parent is, but the staff did not ask for his notes. One way of avoiding this mess and covering his tracks would be to make certain that all notes taken by all medical personnel are transferred onto the patient’s record so there is no…
The time is 1900 hours. You are working in a small, rural hospital. It has been snowing heavily all day, and the medical helicopters at the large regional medical center, 4 hours away by car (in good weather), have been grounded by the weather until morning. The roads are barely passable. WR., a 48 year old construction worker with a 36 pack year smoking history, is admitted to your floor with a diagnosis of rule out myocardial infarction (R/O MI). He has significant male pattern obesity (beer belly, large waist circumference) and a barrel chest, and he reports a dietary history of high fat food. His wife brought him to the ED after he complained of unrelieved indigestion. His admission VS were 202/124, 96, 18, and 98.2°F. WR. Was put on O2 by nasal cannula titrated to maintain SaO2 over 90%, and an IV of nitroglycerin was started in the ED. He was also given aspirin 325 mg and was admitted to Dr. A’s service. There are plans to transfer him by helicopter to the regional medical center for a cardiac catheterization in the morning when the weather clears. Meanwhile you have to deal with limited laboratory and pharmacy resources. The minute WR. Comes through the door of your unit, he announces he’s just fine in a loud and angry voice and demands a cigarette.…
By ignoring the wishes of the patient, the nurse has clearly violated an important tenant of the California Code of Regulations. Situations like this can be very challenging are used to giving orders and not having them questioned. An intimidated nurse is, especially for new, inexperienced nurses. Advocacy is not for the faint of heart and many physicians an unsafe nurse and it is vitally important that nurses speak up when faced with dilemmas like this. If the nurse in this instance was afraid to speak up, he/she should have gotten the charge nurse or clinical manager involved to ensure that Mr. E’s rights were not violated. Laws like this were instigated for precisely this reason, to prevent providers from running roughshod over patient’s rights.…
Karen Thomas arrived this morning for Syncope. She was brought to the hospital by an ambulance. Her alcohol level was O. She already had two negative troponin and was going to be discharged the next day. Basically, she was at our CDU floor for observation and third troponin. After getting a report from the nurse, I went to see the patient to do my assessment. As I introduced myself, I could tell that she was not happy being bothered and staying at the hospital. I completed vitals and assessment, and administered her medications. While I was about to leave, she mentioned that she did not want to be bothered all night. In our floor, we were required to do vitals and a complete head to toe assessment every four hours. Since she was syncope patient…
Doc needs to put a message together to explain to patients what is going on and how this has to be treated. There are ethical obligations, ethical dilemma, and constraints, along with limits to help you decide his course of action. Rights and responsibilities, duties, and obligations are on the docs mind. In this situation he has to decide what his rights and responsibilities are, and what rules should he follow. All patients need to be treated with respect, and you need to be able to handle the consequences and can you tolerate it all.…
A 66-year old Mexican-American man came to the ER on 4-6-2014, for shortness of breath and respiratory distress. Patient also has a history of alcohol abuse, cirrhosis, kidney and gallbladder stones, and renal failure. Patient had family coming to visit and was 10 minutes from the hospital. They were informed the moment they walked into the hospital that the patient was not doing very well. Doctors had to take drastic measures to maintain his heart rate. The patient’s family members were not expecting this.…
That day,I made the decision that my obligation was to my patient and not my fear. As a nurse it is my responsibility to educate my patient and promote health. My patient did not realize the severity of the complications that could arise from not receiving treatment. After being educated my patient decided to stay for the six weeks. Today, when I have patients insisting on leaving against medical advice,I do all that I can to discourage this decision.…
During the first day of my clinical, I had the opportunity to shadow my preceptor because of some technical problem I did not have my login, so I couldn’t have access to the patient records and all the information’s I needed. Consequently, I shadowed my preceptor. In fact, it was a learning since I did observe how she does her charting, reporting, how to start, organize and prioritizes during a shift. The culminant point of the day was the admission of a patient from the PACU. Before the patient came to our unit, there was a great communication between the nurses who took care of the patient before his admission to our unit. The patient had a surgery on his neck and he looked fine at first glance. We assessed him and followed all the protocol…
Advocacy is important at all level of nursing. Advocacy is fundamental for the nursing profession's political power. With political power we can change policies, laws, and regulations and shape both the nursing practice and the work environment. As APRN we should advocate about issues that most affect our practice, our community, the public health, and the social justice. This involves knowing the laws and regulations that govern our practice acts and knowing the process of creating health policy.…
According to, “The American Nurses Association Code of Ethics”, this document sets standards for nurses. It exemplifies the role of the nurse and duties to be maintained. For instance, patient advocacy is an important factor to the code of ethics. Patient safety is to be a primary goal for the nurse. I believe this is crucial for all nurses to practice. Individuals in the hospital are not necessarily capable of always expressing their needs. Therefore, it is the nurses responsibility to advocate for the patient during times they cannot. For example, one time I was caring for a patient who did not understand their diagnosis. A team of residents came into this person’s room and overwhelmed them with information. Confused, the patient was unable to understand the complexity of the illness. However, I witnessed the nurse advocating for her patient. She stepped in as a voice, making sure the patient’s questions were answered before they left. For a patient it can be quite intimidating when a group of doctors come in talking about a disease process they have never encountered. So, it was satisfying to see the nurse advocate for the patient.…
I feel like I’m in an episode of ER or Grey's Anatomy without the pretty people. There were rows and rows of people on gurneys in the hallways. Waiting for a room? Is Michelle going to be one of them? Then there were cops everywhere and they were taking reports and I looked in one room and a woman’s face was completely bloody. And then I heard the word attacked and realized this must be the norm here. Well I guess Michelle was lucky because we got right in a room. So now Michelle is still really, really out of it and they hook her up to oxygen and try to get her hydrated. In the course of being there we saw about six different nurses and two different doctors. She had a chest x-ray, EKG and blood work done and little by little her blood pressure started coming back to normal. All I wanted was to take her home. I hated to leave the room to find a bathroom because I was afraid of what I was going to see out there. You see I can't watch TV medical shows because I faint at the sight of blood. I kept my head down and found a bathroom without getting lost. Finally 14 hours later at 10:30 p.m. we got to go…
Nursing is a challenging, rewarding and exciting career. The nurse 's role is not limited to changing bandages, giving needles and offering support, as the past has indicated. The role of the modern nurse is one of advocate, caregiver, teacher, researcher, counselor, and case manager. The caregiver role includes those activities that assist the client physically and psychologically while preserving the client 's dignity (Kozier, Erb, & Blais, 1997, p.129). In order for a nurse to be an effective caregiver, the patient must be treated as whole. Patient advocacy is another role that the modern nurse assumes when providing quality care. Advocacy is defined as the active support of an important cause, supporting…
A search of the literature reveals several different definitions of patient advocacy. Merriam-Webster's Online Dictionary defines advocacy as "the act or process of advocating or supporting; to promote the interests or cause of " and an advocate as…
Whilst at work I saw the nurse take bloods from a patient which was a monthly routine for the patient it has always gone ok and the patient has been fine with having her bloods taken before. The nurse told the patient it wouldn’t hurt at all. Something happened whereby the nurse couldn’t get the blood and had to re-attempt the procedure. The patient also experienced some pain during this procedure which she wasn’t expecting, the patient found this a quite traumatic experience The patient was elderly and appeared confused. The patient became anxious and next time a blood test was due became increasingly worried and reluctant to have the procedure. She appeared frightened of the needle…
Mary (changed name) was admitted with right cerebrovascular accident (CVA) and was now just waiting for residential placement. One of the side effects left over from her stroke was that she had a drop-foot for which she had a splint and a walking stick; she had declined to use a frame. Mary was one of the patients on my team so I was getting to know her quite well during my first two weeks on the ward. I was working with another patient when I saw Mary twist on her ankle and try to steady herself on her stick. This had the effect of spinning her round and she fell to the floor onto her left hip. I ran to help, she was in a lot of pain and slight shock, I called down the ward for help several members of staff came to help saying "do this" and "do that" all at the same time, I was quite over whelmed. Mary was rolled back and forth onto a sling, hoisted up and placed on her bed, all the while I was looking after her head, I did not know what else to do so I talked to her to calm her down, which was difficult due to all the commotion. On initial examination the senior nurse on duty said it looked like she had broken her femur, which was later confirmed. Her residential placement was cancelled and she was transferred to stepping hill.…