One such example would be, nurses have to frequently assess any change on patient’s condition and notify doctor immediately if there are changes. Delaying may increase the complication and makes it harder to treat. Other than that, nurses must document down all the information in accordance to approved standards of practice which includes evaluation of how treatments work, assessment, compliance, reaction of patient and communication. Evidence by charting can help to prevent liability in a malpractice suit. Lack of documentation can alter the nursing intervention, such as in the scenario which stated medication was not discontinued when the resident was at high risk for bleeding.
Care had to be individualized with each patient and it included providing respect with his or her decisions in their care. An example includes respecting the decision when a patient refused to take lactulose because it made him have frequent bowel movements. In EPIC, we would chart patient refused the medicine resulting in providing patient-centered care. For quality improvement, the unit has data on how many infections have occurred with central lines and utilize benchmarks and evidence-based practice guidelines to prevent infections. For instance, I had to perform proper hand washing and scrub the hub for at least 30 seconds with alcohol pads to prevent infections in patients who have intravenous lines.
Nobody told me how to sit there correctly, and I was lost and sat very slowly. Again, this doctor started to yell at me and say some offensive words to me. This kind of attitude made me cry, because I expected gynecologist to be kind, patient and friendly with girls that have never visited them. Truthfully, due to my emotional stress I even had no words to say. Later, when this nightmare has finished, I was asked to proceed to the doctor’s room for further directions.
Amandeep’s situation was a bit different from mine. In my situation blame goes on all levels of health care; for instance, the patient I took care, had to go for his selective surgery even though he was not in situation for this surgery. His wife was terminally sick and was transferred in palliative care a day after he transferred to rehab unit. When he arrived rehab unit, nurses explained him that usually in rehab there are no passes allowed until the vehicle transfer assessments are done by the therapist. Due to the nurses’ heavy workload, they were being more task focused, the patient was not being heard or being asked why he was anxious or uncomfortable.
For example, my patient complained saying she was in pain and none of the nurse had taken care of her. She was crying and yelling at nurse to take another pain medicine. However, she forgot that she already had taken her medication. Therefore, I learned the big lesson that it’s important to look at the patient’s chart at first and know their diagnosis and symptoms. According to the text, most of the patient with bipolar disorder would do the things which nobody had expected.
Likewise in healthcare, oncoming staff generally does initiate not patient care delivery until a hand off process occurs. “Communication failures are increasingly being implicated as important latent factors influencing patient safety in hospitals.”(Sutcliffe, 2004, p. 187) Parker (1996) reports, “the nurses handing over had direct knowledge of the patient and were able to convey idiosyncratic and personal knowledge of the patient. This is a crucial element in professional nursing practice. The nurse can report on clinical judgments and can be held accountable for the judgments made” (Parker, 1996, p. 25) Critical evaluation of nursing actions can be evaluated and considered to be either continued or discontinued based on the rationales for the action and the patient outcome. In 2005, the Australian Council for Safety and Quality in Healthcare published a literature review of clinical handover and patient safety.
Griffiths et al (2014) stated that frustration is a common problem for nurses who are caring for people with dementia. I think that Margaret’s emotions were the biggest factor that influenced my feelings. The frustration on her face upset me as I desperately wanted to resolve the problem for her. However, part of the problem was me not allowing her to go home. Marquardt (2011) acknowledged that care for people with dementia is made more difficult in the hospital setting as the busy environment can disorientate them and leads to
She described the two difficulties: the first problem for her is caring for the stubborn patients. In hospital, some patients are very agitated, stubborn and sensitive. Caring with those patients is very difficult for her. Sometimes, they refused her to care them. But she tried to give effective care for them.
Based on the standard of practice for nurses and midwives, standard 1 stated that nurses are required to apply their professional knowledge during practice. It is also important to always have a reason for your act as you do and knowing the consequences of doing it (Benner & Sutphen, 2007). If I had more knowledge about MRSA, I would have known the appropriate PPE to wear in the appropriate timing and not creating fear in Mr Lim. Besides that, limited use of relevant knowledge might affect the quality of care and work (Eraut, 2000). In the case, I could not comfort Mr Lim due to my limited knowledge in MRSA hence lack of explanation given to Mr Lim.
I realised during orientated new admission patients, nurses just told to raise bedrail if the caregivers were not around. Although they told the reason, they just read one through the list on orientation sheet. They must emphasize especially bedrails as it is essentials for patients safety. Caregiver must raised it even leaving patient just for a while to avoid falling. It is because unintentional injury in paediatric mainly due to children fall (Messmer, 2012).