On 09-27-2016 at approximately 1310 hours, I, Security Offcier James Argyro A-10280, was dispatched to the security medical station for a employee medical. Upon arrival I made contact with Lisa Bowen A-5954, who stated that she tripped over a bucket behind the bar and landed on her left knee. Bowen stated that she did not report it because it did not hurt and she was able to get right back up. F&B Supervisor Allison Williams A-2318 stated that when she heard about the fall she made Bowen report it to security. Bowen stated that she was not in any pain at this time and did not wish to speak to Emergency Medical services. Bowen was released to her supervisor and given a medical packet. Security Shift supervisor Neil Grant A 3079 was notified.
The worker alleges that he suffered a stroke due to the pressures experienced at work, including negotiating tensions between managerial staff and other employees, increasing volume of demands due to a MYOB file being corrupted and policies and procedures requiring being written, implemented, and presented, as well as material changes to his role. The worker's case is that the stress contributed in a material way to the occurrence of the stroke such as to make it compensable pursuant to section 7 of the RTW Act.
A woman and her 8 month old son come into the hospital. The boy is very thin and wasted looking and the mother tells you he hasn’t been growing at all in the recent weeks. Through interviewing the woman, you discover that their family has come on hard times and in order to cut down on costs, she and her husband have been diluting the boy’s formula and have not yet introduced him to solid foods.
The formal “authority” for this issue is WA State Central Region EMS and Trauma Council with Harborview Hospital being its leader. Harborview’s authority in King County was established well before this issue arose. A top-down approach is being used to control the resolution of this issue. This is a driving force. It works well because “the environment is stable and tasks are well understood.”
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
The national fall rate is between 2.3-7.0 falls per 1000 patient days in hospitals, costing hospitals approximately an additional $4,200 per fall (Kalman, 2008). The numbers of falls that happen in hospitals are inevitable. They have caused injury and death for many patients while being hospitalized. It has also put on a toll for the hospital with the amount of money they have to spend that could be spent on other things, especially when this is something that can be prevented in a hospital setting as healthcare members are there to help, and are continuously in and out of patients rooms. In fact, this has become significant recently, as insurance companies are no longer willing to pay for falls that happen in hospitals, along with many other things. “In 2006, there were 2,591 cases reported of Medicare patients who fell out of bed” (Woodward, 2009, p.201). However, the bigger thing to recognize her...
The Lewis Blackman Case: Ethics, Law, and Implications for the Future Medical errors in decision making that result in harm or death are tragic and costly to the families affected. There are also negative impacts to the medical providers and the associated institutions (Wu, 2000). Patient safety is a cornerstone of higher-quality health care and nurses serve as a communication link in all settings which is critical in surveillance and coordination to reduce adverse outcomes (Mitchell, 2008). The Lewis Blackman Case 1 of 1 point accrued
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
“Staff in the med-surg unit are told that they must now educate all patients and families on falls prevention on admission and document it, regardless of the patient’s reason for or severity of admission, and along with everything else that they are asked to do with patients when admitted”(Scenario 3).
I had a patient that was a threat to others, was not redirectable, and was refusing to come out of the bathroom. I informed the doctor that this patient was threatening staff, the doctor told me what to give; nurses usually collaborate to get security, additional staff, draw IM medications, etc. As another nurse and I were drawing up Haldol, Benadryl, and Ativan, the doctor peeked in and told us not to bother, that the patient was now calm. This patient was refusing all PO medication and was grossly psychotic. It did not matter if in that instance she was calm, she was a threat to staff because she had threatened them, and my note reflected this. When I gave report to the next shift, I warned them. The next day in morning report the evening/night staff reported that security was called and that this patient had to be medicated. This doctor does not understand, that if this patient had hurt staff, the doctor would be liable because my note stated that she was a threat and that the physician refused to medicate. This doctor was angry at me because I documented the facts, so
“Health administrators have an ethical obligation to provide a working environment that is safe and does not harm employees” (Morrison, 2016, p. 56). It was not ethical from the supervisor’s perspective to blame Lawanda alone for the error without knowing the actual underlying cause of the situation. The supervisor accused Lawanda of killing the patient and warned her that she should report herself to the state board of nursing. Threatening the novice nurse with jail time and suspension was not correct. The supervisor demonstrated a lack of empathy towards Lawanda and harassed her, ordering her to finish the shift without understanding her feelings of grief. The supervisor’s actions led to the death of Lawanda. This explains that the supervisor caused an intended harm to Lawanda through her actions, which is unethical. Hence, it is the responsibility of a health care administrator to promote a healthy work environment that is free from harassment, imposition, and discrimination (ACHE Code of Ethics,
My practicum was at the Johns Hopkins hospital “Comprehensive Transplant Unit” where I spent over 146 hours. This unit experiences at least two falls a month. One of the fall accident happened during one of my day shifts. A 64 year old patient who had a history of A-fib and generalized weakness and fatigue was left alone in the
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.
Crews can either save their butts or dig their own grave, depending on how thoroughly and accurately they document a call. Documentation, when performed properly, is the best friend of any emergency medical service technician regardless of their level of training because it can serve as reminder years after an incident has occurred by re-creating the incident and describing the reasons specific actions were taken and treatment administered or withheld depending on the circumstances. When done improperly documentation, for example, can open avenues for claims of negligence or a failure to act because standard and accepted medical treatments were not performed per the written documentation of the incident even if they were performed or the patient experienced an adverse reaction that was unforeseen. It is for reasons like this that accurate documentation of an incident is critical to a provider's professional reputation, description of the provider's ability to provide adequate and accurate medical treatment and perform specialized
The reason for this essay is to reflect on a critical incident experience during my six week placement as a student nurse on an orthopedic ward. To explore an event as a critical incident is a value judgment, and the basis of that judgment is the significance attached to the meaning of the incident. Critical incidents are created or produced by the way we look at a situation. Tripp (1993)
The nurse confirmed patient identification, asked subjective questions focusing on chief complaints, performed a focused assessment, obtained medication list, baseline vitals, and assessed the patient’s past medical history. She asked the patient questions such as previous hospitalization/surgery, metal implants, allergies, health history, sleep apnea, and alcohol/tobacco use. The nurse told the patient the doctor would be with her shortly. The nurse reported to the doctor regarding the patient and obtained orders for treatment from the doctor. The nurse then started an IV line and hung an IV solution bag of normal saline because the patient was experiencing abdominal pain. The nurse also administered pain medications and the patient was ready to be discharged. The nurse gave discharge instructions and made sure that the patient had a ride