Emergency Room Emergency is defined as a serious situation that arises suddenly and threatens the life or welfare of a person or group of people. An emergency department (ED) or also known as emergency room (ER) is a department of a hospital concentrating in emergency medicine and is accountable for the delivery of medical and surgical care to patients arriving at the hospital needing an immediate care. Usually patients will arrive without prior appointment, either on their own or by an ambulance. For my clinical observation experience I went to the Emergency Department at JFK Medical Center. The first emergency nurse I was assigned to was responsible for six beds. When I first arrived the nurse explained to me that she prioritizes her care based on urgency and airway problem. Since the rest of her patients were stable, she went to perform a focused assessment on a new patient assigned to one of her beds. This patient came in because he had fallen in the bathroom. As soon as she was finished assessing this patient, she went to the …show more content…
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
On May 20th, the patient, Mr. Ard, experienced nausea, shortness of breath, and pain while being treated in the hospital (Pozgar, 2014). The patient’s wife, Mrs. Ard, attempted many times to reach a nurse by pressing the nurse call button (Pozgar, 2014). Once the nurse finally responded, anti-nausea medication was administered (Pozgar, 2014). Mrs. Ard continued to monitor her husband’s situation, and felt as if the nausea and shortness of breath were getting worse (Pozgar, 2014). Mrs. Ard continued to ring the nurse call button for approximately 1.25 hours prior to a response from a nurse (Pozgar, 2014). A code was called, and Mr. Ard did not survive (Pozgar, 2014).
When the practices in the healthcare delivery system or organization threaten the welfare of the patient, nurses should express their concern to the responsible manager or administrator, or if indicated, to an appropriate higher authority within the institution or agency or to an appropriate external authority” (3.5 protection of patient health and safety by acting on questionable practice, ANA, 2015). The example of the practice is a patient discharge from the rehab facility to the Personal care unit with pending PT/INR results, which turned out to be critical. The admitting nurse demonstrated moral courage by questioning physician who wrote discharge orders and the nurse who completed discharge. Rehab physician refused to address lab results and referred the patient to the PCP. Admitting nurse raised a concern to administration to review discharge protocol and deviation from safe practice. Nurse acted on behalf of the patient and requested readmission to rehab based on patient’s unstable medical
The emergency department (ED) is an essential component of the health care system, and its potential impact continues to grow as more individuals seek care and are admitted to the hospital through the ED. Invasive procedures such as central lines are placed with increased frequency
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.
She should have not made the assumption that there were no doctors available until 2100 hours. Instead, she should have sought clarifications on whether the Emergency Department (ED) doctor was prevailed on examining the patient. She should’ve escalated concerns to the Clinical Nurse Manager (CNM). She also should’ve not made the assumption that the administration of antibiotic would improve the patient’s condition and “recover” her from the “red zone”. Finally, she should have documented her observations and implement a care
the patient was in pain, and I decided not to give him bed bath instead I explained the situation to the nurse, and she administered pain medication.
JB McKenzie, et al. "STRATEGIES USED BY CRITICAL CARE NURSES TO IDENTIFY, INTERRUPT, AND CORRECT MEDICAL ERRORS." American Journal of Critical Care 19.6 (2010): 500-509. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
However, we are looking at a case study where patients safety has been compromised, professionalism has been voided, lack of communication, nurses aren’t liable for their work, the duty of care has been breached and lot more issues can be discovered. Which will be incorporated in this paper. Looking at the patient Christopher Hammett
I escorted her to a room, and helped her change into a gown. I understand that a 22-year old is capable of changing her own clothes, but I wanted to spend more time with her for further investigation. Auscultation of the lungs revealed bilateral clear and equal breath sounds, and heart tones were audible and regular. No peripheral edema was noted upon examination of her lower extremities, and she denied a history of similar symptoms or any medical issues in the past. Again, my nursing experience was challenged. Everything looked great, except this feeling remained that something was wrong. ER was busy that day, so I put in on order for a chest x-ray, and then told the doctor why she wanted to be seen. I told him that I ordered an x-ray, but something was not right about her skin color, not jaundiced, swallow, or cyanotic just not right, and I asked for basic lab work. The doctor felt lab work was not needed at that time, and I did not push the issue. I just thought to myself, “maybe he is right, and I have worked too many days in a row”. When the patient returned from the x-ray department, I met her at the room. I asked how
When I was working as a bedside nurse in the Emergency Department, in one of my duties I was not satisfied with the treatment plan made by a resident doctor for XYZ patient. He entered intravenous KCL (potassium chloride) for the patient. The purpose of that medication and its dose for that patient was not clear to me. I assessed patient history and came to know that a middle aged patient came with the complaint of loose bowel movements, vomiting, and generalized weakness. His GCS (Glasgow comma scale) was 15/15, looked pale but was vitally stable. I exactly do not remember about his previous disease, social or family history but I do remember that he was there with his son. According to the care plan, I inserted intravenous cannula, took blood
The patient in question was admitted with suspected pancreatitis. This piece of reflection will pay particular attention to the care I gave the patient in the form of instigating admission documentation, assessing their condition, instigating care plans and administration of any medications required. The patient in question had complex needs and as a staff nurse and according to the NMC (2009) I should be able to provide the care he/she required.
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
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
Working in the emergency department can be easily described as fast placed and at times hectic. Being aware of resource management and learning to prioritize patients are skills that are required to be learned quickly. Once a basic understanding and knowledge of these skills are acquired, nurses are able to build off of them and adapt them however they see fit.