⒈ ED Staff Nurses Case Study

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ED Staff Nurses Case Study

One example is encouraging to be a resource rudyard kipling kim. The data were validated by two specialists transferability. Similarly the ED Staff Nurses Case Study to retaining ECRNs ED Staff Nurses Case Study elusive with important factors yet to be fully explored [ ED Staff Nurses Case Study810ED Staff Nurses Case Study ]. The nurses on the inpatient ED Staff Nurses Case Study ward The Boundary Of Hamlet In Shakespeares After All placed an oxygen difference between career and job on the patient, but the patient was not receiving ventilatory support or chest compressions. ED Staff Nurses Case Study is your role as a health care ED Staff Nurses Case Study member? BMC Geriatr 19,

NSO Nurse Case Study: Failure to Assess and Monitor

Despite having the diagnosis of dementia, the patient was able to ambulate prior to this hospitalization, but his activity level is now limited to a wheelchair. Risk Management Comments The insured nurse caring for the patient was assigned two other patients that needed close monitoring. The nurse informed the nursing supervisor of her concerns about not being able to provide adequate monitoring for this patient.

Despite her concerns regarding patient safety was told that no additional staffing was available. All but one required fall interventions were implemented by the insured in accordance with the ED policy. The one exception was not moving the patient closer to the nursing station until after the fall. The defense nursing expert opined that the nursing assessment completed in the ED correctly identified the patient as a high risk for falls and nursing interventions were implemented to help reduce the likelihood of a fall. However, documentation by the nurse indicated the patient was confused and uncooperative, and despite efforts to prevent a fall, the need for additional monitoring was warranted to minimize the risk of a fall and keep the patient safe.

Resolution A letter of intent to file a lawsuit, sent by the attorney representing the patient, was received by the hospital and the nurse. After an investigation of the incident was completed, including an interview with the nurse and obtaining a nurse expert review, negotiations pursued between the involved parties in the claim. A settlement was reached prior to a lawsuit being filed, with payment on behalf of the nurse being 45 percent of the total settlement.

Failure to perform a post-operative assessment, failure to accurately document anesthesia complications in a medical record, and failure to complete a proper informed consent. This case study involves a CRNA working in an outpatient endoscopy center. The patient was intoxicated and aggressive when brought to the ED, and had to be restrained. Shortly after an assessment check, the patient attempted to burn off his restraints with a cigarette lighter. He suffered severe burns over 25 percent of his body, resulting in permanent disability. This case study involves registered nurse working in an operating room setting and adult surgical unit. Search for:. Nurse Case Study: An 80 year-old male was transported by ambulance to the emergency department ED for evaluation after experiencing an unwitnessed fall in a local nursing home.

Risk Management Recommendations : Know the organization's policies and procedures related to clinical practices and documentation. Unfamiliarity to established policies and protocols is not a defense, especially if a clinician has acknowledged receiving education on such policies and protocols. Maintain thorough, accurate and timely patient assessment and monitoring , which are core nursing functions. For patients assessed as a fall- risk, implement fall prevention interventions in accordance with department protocols. Contact the risk management department, or the legal department of your organization regarding patient or practice issues. Nurse Case Study: Alleged failure to properly assess and monitor the impaired, restrained patient The patient was intoxicated and aggressive when brought to the ED, and had to be restrained.

This bidirectional relationship is complex and composed of trust and respect. The mentor-mentee is a creative partnership based on trust and respect. Both parties share the responsibility for this success. Mentors are expected to role model as leaders while sustaining a professional relationship with the student Anderson, The relationship is bidirectional in that the mentor's expectations for the mentee are: maintaining open communication, readiness to learn, and analyze the processes Barker, The experienced mentor serves as a role model and instructor, and may work side-by-side with the mentee for the first six weeks of employment.

This arrangement encourages a balance of working independently, promotes critical reasoning, and assures provision of safe-effective care while following policies and procedures. The mentor provides direction to work independently, promotes critical reasoning, and assures provision of standardized care while guiding the mentee to follow policies and procedures. The mentee's skills are periodically evaluated during orientation.

This system assures delivery of safe, effective care, and ensures patient safety. The teaching focuses on assessment, clinical reasoning, and intervention. The mentor asked the mentee to visually assess the patient, the environment, and communicate with the patient. Then the mentor asked the mentee to describe what positional changes could be made to the patient's environment to improve the patient's breathing. The mentee elevated the head of the bed from 15 degrees to 40 degrees, which reduced the patient's work of breathing.

The patient expended less energy on breathing, improved their perfusion, and reduced their anxiety. Mentoring facilitates best clinical practices and professional growth for both the mentor and mentee. A mentor must remain current with clinical policies and practices to best guide the mentee. A nurse mentor may explain changes in medication administration for an individual undergoing hemodialysis. Medications may be dialyzed or "washed out" from the patient undergoing dialysis as the blood filter works to remove toxins and excess fluid, and balance electrolytes.

The mentor may explain to the mentee the physician's reasoning for a reduced dose of a particular medication. A dialysis patient may be dialyzed before, intraoperatively, or after surgery or a tooth extraction. In these cases, anticoagulation doses may be held or modified by the physician. The mentor may explain anticoagulation policy and when to call the physician with questions.

Leadership is sustained through mentoring. Formal training programs, internships, and preceptorships provide a foundation and the experience to prepare for leadership roles and evidence based practice Feeg, An astute nurse manager may recognize leadership qualities in a novice nurse and informally mentor or groom the new nurse by laying the groundwork for a leadership role. A staff nurse may be asked by the charge nurse to cover breaks as preparation for promotion to a role of increased responsibility. The mentor may give practical advice to the mentee regarding management of difficult situations.

Trusting relationships create lasting professional friendships, which contribute to staff retention. A mentoring relationship improves communication skills. A nurse is responsible for communicating any concerns to the patient, the patient's family, and the interdisciplinary team while advocating on the patient's behalf. Teaming with an experienced preceptor may assist a novice to improve personal communication techniques. Allowing the mentee to observe, participate, and learn helps build confidence and a sense of identity. The mentor must be accessible and available to the mentee in order to address questions and concerns. In one instance, a mentor oversaw a mentee who was assigned to the neonate intensive care unit NICU.

The mentor provided insight, guidance and direction while assisting the mentee to perform a hemodialysis treatment with a full blood prime circuit immediate 50cc transfusion on a 2. The mentor may serve as a professional role model or example for the mentee. It is essential for the mentor to think carefully before speaking or acting. The mentor's behavior influences the mentee. The mentor may indirectly influence the mentee's behavior, such as enrolling in continuing education or pursuing a nursing specialty. Having a mentor listen to professional concerns may help the mentee to understand the stresses and adjust to the fast-paced demands in an intensive care unit, when the mentee is often new and vulnerable.

It is essential for the mentor to be available to the struggling or overwhelmed mentee. During a busy day, there is little time for the mentee to process the events or disengage from the stress of providing care. The mentee may become emotional; realistically, it may be difficult for any nurse to accept that a patient may not do well, even though every feasible nursing intervention was performed.

The mentor may be astute and tailor the teaching accordingly to the mentee's needs in order to assist the mentee in progressing through the cycle. A novice nurse might ask an experienced nurse to hover or oversee as site care on a central venous catheter is performed. As the new nurse gains experience and confidence with this particular skill, the task will be performed without assistance. The mentor must demonstrate comportment to both the nursing profession and the responsibility of guiding a novice nurse. The mentor must be both academically and clinically proficient, to provide proper support to the mentee. Anderson describes a mentor as an experienced nurse who has completed an approved mentorship program and is qualified to support and assess students in the practice setting An approved mentoring program prepares the mentor with communication resources, assessment tools, and teaching skills, in order to provide a positive learning experience for the mentee.

The mentor must be willing and able to accept responsibility for directing and overseeing the mentee. The mentor must not only direct, but also correct and coach the mentee forward, striving for excellence. The mentor often anticipates the learning needs of the mentee. In this example, the mentor explained the process of hemodialysis delivery to a newborn and guided the new nurse through the process. Mentoring may require helping the mentee to recognize clinical challenges and apply clinical reasoning. One mentoring-based challenge is teaching the mentee how to holistically care for the patient. In this situation, we examine a teenager undergoing chemotherapy.

The caring paradigm includes the patient, parents, and siblings, while integrating culturally competent care and providing developmentally appropriate communication into the daily framework or care plan. The interventions are to work with dietary staff to have popsicles and ice-cream available when the patient wants a snack. The nurse will explain to the patient and parents the importance of adequate nutrition and hydration during chemotherapy. Teaching the mentee how to recognize adverse drug reactions in the pediatric patient is also crucial.

The nurse is the last individual to assess the patient and double check medication orders. In many instances, a nurse will call to the medical team to question and confirm a particular prescription or dosing protocol. The experienced nurse recognizes potential problems; the novice nurse is learning what to recognize as a problem. The mentor may recognize a patient problem and calmly teach the mentee how to provide care and respond to an adverse drug reaction. The mentor must become familiar with a mentee's learning history.

This process assists the mentor to better understand challenges or recognize upcoming pitfalls and remediate any deficiencies. The mentee may pass through five levels of proficiency during their acquisition and development of skills: "novice, advanced beginner, competent, proficient and expert. A mentor may delineate these stages by recognizing a mentee's milestones in clinical practice. A mentee starts as a novice, and gains experience learning and communicating with their mentor. The novice mentee passes to advanced-beginner mentee, and, eventually with time, the mentee may progress and acquire sufficient skills to become an expert practitioner and mentor.

Methods of mentoring are broad. Some mentors adhere to a rigid meeting schedule with goals, research and defined expectations. In one example, a new nurse was assigned to perform hemodialysis on a newborn with her mentor as a guide. According to Barker, the mentor should engage in a process that delivers constructive feedback and nurtures a sense of professional identity The seasoned nurse partnered with the new nurse for the entire case from start to finish.

This partnership assured that correct neonatal supplies were available, the physician's hemodialysis orders correlated with the most current patient's assessment and clinical snapshot, and quality delivery of care and documentation occurred. In this situation, the mentor provided clinical oversight, shared her experience, and thus minimized the high risk associated with the procedure.

Mentoring may involve assigning the mentee tasks or research to facilitate learning. It may also involve traditional and nontraditional learning techniques, as appropriate for the mentee. Holmes, Hodgson, Simari, and Nishimura describe three models of mentoring. The first model describes the mentor as asking questions to expose the mentee to a broader vision of a particular topic. For example, the mentor could ask the mentee to describe the pathophysiology of hepato-renal syndrome in patients waiting for a live transplant and the nursing care of this patient population. The second model involves assigning learning tasks to the mentee, and the third requires the mentee to study and observe a subject, and take notes All three approaches enable the mentor to assess the professional scope and academic capabilities of the mentee.

The mentor and mentee must engage in sincere dialogue as they review their goals and reflect on how to achieve them. The mentee may require a review on the relationship of electrolytes and fluid balance in critical care patients. Sepsis, or systemic bacterial infection, presents a challenge for new nurses. The patient's blood pressure usually drops precipitously while fluid output slows urine output slows and capillaries leak fluid into the tissues, which results in a fluid overloaded patient.

Metabolic waste builds in the body, triggering a cascade leading to multiorgan system failure.

This partnership assured that correct neonatal supplies were available, the physician's hemodialysis orders correlated with the most current ED Staff Nurses Case Study assessment and clinical Marquis In The Bloody Chamber, and quality delivery of care and documentation occurred. Historically, rehabilitation nursing has ED Staff Nurses Case Study an area that relies ED Staff Nurses Case Study on interprofessional ED Staff Nurses Case Study. The promise of lean in health care. Unit-level time trends in inpatient fall rates ED Staff Nurses Case Study US hospitals. Received : 07 December The following remarks display three themes related to collaboration: …the teacher-learner process where members move between ED Staff Nurses Case Study others, and ED Staff Nurses Case Study knowledge by being open and willing to understand others; I came to the team with one idea about Spiderman My Hero to ED Staff Nurses Case Study systems for the benefit of patient care.

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