The patient is a 78-year-old gentleman who is brought to the emergency room because of increasing confusion. Evidently the daughter has taken to the bank to get some money when the daughter try to assist him to put his money in his pocket he became aggressive and combative and began to swing at her with his cane and then walked off. She was the unable to find for approximately 4 hours. When he was found he was brought to the emergency room. In the emergency room the patient was placed initially in observation status. Despite being treated in observation with fluids he remained confused and somewhat aggressive and it was determined that the patient required acute inpatient hospitalization. His medical history is significant for hypertension,
In July of 2010 in Miami, Florida, Richard Smith, a 79-year-old dialysis patient was admitted to the ICU after a dialysis appointment left him with severe shortness of breath. The following day after being admitted the patient complained of an upset and the doctor had prescribed him an antacid. Uvo Ologboride, the nurse taking care of Mr. Smith, gave him a deadly dose of a drug called pancuronium, which is a drug that induces paralysis, instead of the antacid. 30 minutes later the patient was found unresponsive, but they were able to revive him. Unfortunately when he was revived, he was left brain dead to which did not settle well with his family. When the patient son had came in he had found his father unconscious, unresponsive, and on a respirator. When looking over the chart to try and figure out what happened it had said his dad had just been resuscitated 10 minutes earlier and the nurse had pretty much told him to go and speak with the doctor. Upon speaking to the doctor he was told the nurse had given his dad the wrong medication which lead to his current state of his condition. The nurse was not able to be reached and spoken to about what happened on that fatal day but from what the doctor had explained was the nurse had grabbed a
Symptoms/Focus: Dr. Andrew Bourgeois at Simi Valley Emergency Room requested an evaluation of client by the Crisis Team for Suicidal Ideation and Grave Disability. Client placed a call to EMS on his own behalf on the evening of 05/14/2017. Client requested to be picked up from in front of a restaurant and taken to Simi Valley Emergency Room due to suicidal ideation with a plan to "cut head with a saw". Client stated to Dr. Bourgeois that his depression had increased over the last 3 days. Client denied drug or alcohol use, but was positive for amphetamine in the hospital toxicology screen. Client had been seen at Simi Valley ER and
The patient is a 45 year old male who was in a car accident that
Mrs. Ard brought a wrongful death law suit against the hospital (Pozgar, 2014). The original verdict found in favor of Mrs. Ard, but the hospital appealed the court’s ruling (Pozgar, 2014). During the course of the appeal, an investigation of the records showed no documentation, by a nurse; of a visit to Mr. Ard during the time that Mrs. Ard stated she attempted to contact a nurse (Pozgar, 2014). The nurse on duty stated that she did check on Mr. Ard during that time; however, there were no notes in the patient’s chart to backup the claim that Mr. Ard had been checked on (Pozgar, 2014). One expert in nursing, Ms. Krebs, agreed that there was a failure in the treatment of Mr. Ard by the nurse on duty (Pozgar, 2014). ...
An ALS ambulance crew was dispatched to a 69 year old obese male whom upon their arrival was seizing. The crew suspected this seizure was due to his past history of epilepsy, but because of the patients altered conscious state the paramedics had to consider and rule out other possible causes for his convolutions.
A confused man presents into the Emergency Department in a dishevelled and unkempt state, the nurse assigned to this patient recognises the following; the man is in his mid-sixties, confused and disorientate, anxious, has an acetone breath odour, also at examination locates a haematoma on the right side of his forehead while the patient also states repeatedly that he wants to pass urine. As acknowledged previously the nurse responded in an inappropriate manner therefore making a significant impact on the care of this patient for the upcoming shift, the nurse presented signs of neglect thus actions need to be taken to keep the patient safe with the best suitable care possible.
At admission, Mollie’s main complaint was right hip pain. She was not oriented to person, place or time, responding with “I don’t know” to questions asked. While the emergency department nurse completed a physical assessment, Molly’s hospital record was retrieved. Molly was discharged from the hospital two weeks ago, having been admitted for dehydration. Her health history was significant for hypertension and diabetes. Her primary care provider and home health care information were included in Mollie’s hospital record, as was her daughter’s contact information. The emergency department performed an x ray to evaluate Mollie’s right hip pain and there was no evidence of a fracture. Per MD order, labs and samples were collected and processed: CBC-diff, CRP, hyperal, blood culture, prealbumin level and urinalysis. Molly was evaluated for sexual assault and the appropriate samples were gathered. The forensic nurse gently scraped material from underneath Mollie’s fingernails. Bruises were measured and age of each bruise was estimated by
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
During my time in the Critical Care Unit, I was able to observe Kylie, who is a RN. She has been working in the CCU for two years. Kylie became a RN by receiving associate's degree, and then later went back to school and received her BSN. Kylie started working as an RN before returning to school to receive her BSN. My day in the CCU was a pretty mellow day, not much was going on. There were only around 10 patients in the CCU while I was there, the CCU can hold up to 16 patients at one time. Most of the patients admitted to the CCU were elderly patients who had a hard time breathing. For the patients who had trouble breathing,the respiratory therapist would come to their rooms and would perform breathing exercises with them. There were two other
He is admitted to the ward with the chief complain of pain at right lower quadrant of the abdomen for 8 hours prior to his admission.
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.
In my first clinical rotation I worked in an Urgent Care clinic that has actually turned into the primary care site for a large number of patients. I met a young women age 24, who had been seen in the Urgent Care five times in the past year for Genital Herpes. She did not understand that the suppressive medication ( Famciclovir ) was prescribed to be taken daily to prevent the outbreaks. My preceptor was a bit irritated with the girl- because she was non compliant. She was also frustrated that the girl did not follow up with a GYN provider as she was told too. The girl had good insurance and could go to any GYN in the area. My conclusion was that she was too embarrassed to go to a single provider, and to be accountable for her own health. It was less intimidating to come to Urgent Care.
The word patient visit really makes me nervous. This was my second patient visit; however, I was still a little high-strung. When we arrived at the home, the patient was holding the door open for us to come in. I felt a relieved when I saw him outside and excited for us to be there.
Hospitals are a necessary part of every individual's life. When one thinks of hospitals, help comes to mind (Hospitals Struggle to Keep Their Promises). Neither a person's age, ethnicity, nor economic background should matter when it relates to access to healthcare. Everyone will need hospital care at one point in their lives, no matter how healthy one may think he or she is. That is the reality. Unfortunately, many of these organizations are in danger. "Hospitals are experiencing a period of financial duress unprecedented in recent history. The number of hospitals that have closed their doors is at an all-time high, and many more might close within the next few years" (Moore et al, 1999). It is ironic to think that the institutions such as Faith Community Hospital that provide healthcare and even save lives, face severe problems. Problems that must be addressed early to avoid jeopardizing an individual's access to healthcare should those same problems lead to the hospital's demise.