My perceptions of this clinical rotation totally changed from the mangers story. When she says, “I had to fall back on understanding” and that there was “no policy or procedure to reference” she just had to do what was right (Cathcart). She knew that the patient comes first and the ethical dilemma that was at hand said to ensure that the patient got the best care and all patients were cared for. She was ensuring that the patients on the floor would be covered while another nurse was gone. In the meeting today we talked about the ER nurse delivering a patient to the floor for hand off. The discussed how to do this hand off safely but not having a nurse leave the floor for safety of the other patients. Now it was not life and death at the moment
I started in a meeting with the floor nurse leaders and manager. They talked about staffing issues. Afterwards, I followed a charge nurse as they rounded on patients to assess satisfaction. They also cleaned up along the way and checked the crash carts. After lunch, I was with the manager doing staffing inputs for PTO. They have central staffing, but the manager does do the time off request for her unit (Yoder-Wise, 2015). Emotional intelligence in chapter one explains that being aware of ones emotions from specific situations in order guide thought process and actions (Yoder-Wise, 2015). Three good things about this clinical would be that there is a lot more to leadership then sitting in an office, I get to learn more about the network and how they operate, and I get to learn tips on how to get hired and what they are looking for. Three challenges to my success in this clinical rotation would be getting lost in the large unit and hospital, not having as long of interaction with the patients and having to visit all 30 of them [and know their issues], finally would be not being able to speak up always in meetings. I love to give ideas or comments but I know that these situations are not the best time, unless asked to do so. Therefore, I had to show restraint today in meeting by not talking and reminding myself not to fidget, since it’s hard for me to sit long periods of
The environment seems to be very welcoming. The coworkers get along and communicate well; they also work as a team. The attitudes and behaviors of the unit correlate with what the mangers expectations were; which correlated with the books definition of organizational culture in chapter eight (Yoder-Wise, 2015). There was discussion of being on time to work; but other than that, the spirit and work ethic was high. They were accustomed to all who were working and what was expected of them. Whenever a call light went off no matter who it was if you were close you went; even the manager would go into answer lights. The manager said as a nurse I should be an example and do what I ask of them as well. They know what their job description is coming in and they are working on clarifying it even more. There is a bulletin board with their mission and vision as well as other learning tools and cards of appreciation. Even though there is a hierarchy in a way, they all work together to do the best for the patients (Yoder-Wise, 2015). It is so seamlessly flows as a beautiful unit
I agree with you that the nurses violated provision 9 of the nursing code of ethics. Nurses have an obligation to themselves, their whole team and to the patients to express their values. Communication is key in a hospital, so everyone knows what is correct and what isn’t within the workplace. In order to have a productive, ethical, positive environment. These values that should be promoted affect everyone in the hospital, especially the patients, and can have a negative outcome if those values are not lived out. Nurses have to frequently communicate and reaffirm the values they are supposed follow frequently so when a difficult situation comes along that may challenge their beliefs they will remain strong and their values will not falter.
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
I have come to fully understand that in order to treat my patients in a way that is person centred, I have to treat each person as an individual and realise that every individual has different needs and different rights and preferences to me which may go against my morals and beliefs but I always have to maintain my professional boundaries and treat each individual with respect and dignity. If I was a nurse who witnessed a similar situation to Kat’s, where another healthcare professional was disregarding my patient or any patients views or requests I would go into the patient’s room and find out what the problem was. Then I would politely ask the healthcare professional to step outside of the room and I would gently remind them of the code of ethics ((Kozier, Erb's & Berman, 2010, p.97) and the Registered Nurses standards of practise (2016), and how every individual has the right to make their own independent decisions about their healthcare needs/goals based on their own values, morals and beliefs. I would further explain that the patients are our main priority and it is our responsibility as nurses’ to ensure that the patients are safe and are receiving the proper care. I would then explain to the patient what was happening and apologise to them about the situation, and I would rearrange and try to negotiate with the patient when the procedure could be performed. Then I would notify the Nurse Unit Manager on the ward to ensure that situations like this do not occur
I enjoyed interacting with the patients, and my nurse. Karie, was amazing. She explained to me everything she did. The routine for each patient was very similar, and this repetition helped me anticipate what Karie needed and helped me feel fairly confident in assisting her with the new patients and their needs. On the other hand, I was extremely disappointed that I was not given the opportunity to administer an intravenous (IV) line. Karie was willing to allow me the opportunity after I watched her place an IV in three different patients, but her fourth patient was transported from a different hospital with peripherally inserted central catheter (PICC) line in place. It was beginning to get late in the day and the patients coming in was slowing down, so Karie told the nurses at the nursing station that I needed to practice IV’s, but no one had any to give. Although I was disappoint that the opportunity to insert an IV into a patient did not arise, I did gain much knowledge regarding the ODS unit. I am now familiar with the physical layout of the unit and what takes place with patients that go there. I know the role of the nurse. I was also given an opportunity to practice nursing diagnoses on a
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...
Hood mentions, “determining the presence of more than one ethical concern” (Hood, 2013, p. 70), which I felt was the provider asking me to do something she knew was wrong, knowing there were other available resources, and asking me to do something that I had never assisted with or trained to do. After identifying the problem, I needed to identify the morally relevant facts, which takes a closer look at the context of the dilemma (Hood, 2013, p.70). As mentioned before, the doctor seemed at ease knowing what she was doing, telling me the plan, which is a cause of concern for any future outpatient nurse who may possibly work with her, but doesn’t speak up or isn’t aware of her limitations. In this experience, I needed to stop and think to myself, is the choice that I am making legal within my institution and under my scope and license? From there I evaluated the problem, Hood mentions, “examine the ethical norms by reviewing the literature, code of ethics for nursing” (Hood, 2013, p. 70). After encountering that situation and speaking with my manager, I wanted clarification on my job duties as some nurses say it’s a “gray line”, where it depends on your comfort level or the physician you work with in doing things that the nurse possibly shouldn’t be doing. My manager clarified with me that I legally shouldn’t have even offered to go with her
While on the unit I made sure to use my time wisely, I completed my assessment in a timely manner, advocated for pain medication, checked on fellow nursing students, and kept patient’s rooms organized and clean. Professionalism was also exhibited in my clean outfit, with my hair back, name badge on, nails cut, and appropriate footwear and clinical tools on hand.
I feel as if the patient’s are our number one priority. They come to us for help, and we should be there for them and advocate their wishes. The code of ethics was put in place partially for this reason, to make sure our patient’s have top of the line care. When a patient comes in and states they are in pain, they should be treated as if they are in pain. If a patient declines a medication due to the route and location, then the nurse and physician should work together to form another option. A patient should never be sent away without being treated first. One recommendation I would make is to form an algorithm for pain treatments, just as they do for cardiac arrest. That way when a patient comes in and declines the first option, there is a protocol in place that includes other options. I would also recommend transferring the patient to another unit to be treated if fast track does not have the resources. The patient should also be informed of the treatment right away before making them sit and wait for
Nurse workplace environments have only really been studied during the last decade. There is growing research in this area especially due to the nursing shortage. International consensus is if you identify opportunities to improve working conditions for nurses, you will have a higher probability of maintaining staff (4). The success rate of retaining
It was a very slow environment and because of this I was a bit bored most of the day. The nurse spent most of the morning catching up on documenting incidences that happened the day before. Most of the activity that we saw when I was there happened right after lunch and everybody came in from the playground. The most enjoyable times for me was when we went to the special needs center to check on one of the kids with diabetes. The teachers in that classroom are amazing for being able to know how to teach and handle kids with learning disabilities. I learned that the school nurse is a lot slower environment and has its advantages if you are a parent. It is very important though, a lot of the kids that came into the office where just seeking attention and approval. A school nurse needs to be able to pick up when something is wrong with one of the students. My biggest weakness during the clinical experience was being able to communicate well with the kids. Since communication varies with the different age groups and there are so many different ages in the middle school, I had difficulty transitioning from talking to the older kids to the younger kids and vice versa. Since each of the kids grow at different rates it was also hard sometimes to tell which kids were the older ones. Since the older ones are on the brink of being teenagers and don’t like being treated like they were
Studies have shown that an ideal patient care setting would be an all RN staffing, where the “safest care is delivered by the most-educated bedside nurse” (Bellury, Hodges, Camp, & Aduddell, 2016, p. 345). However, “Driven by competitive market practices hospital administrators are embracing restructuring. They are radically altering the skill mix… and thinning the ranks of their skilled registered nurses (RNs), often substituting cheaper, inexperienced, personnel and minimally trained unlicensed assistive” (Orne, Garland, O’Hara, Perfetto, & Stielau, 1998, p. 101). Hence, delegation of task has become a common practice where as cited in Learning House (2007), some aspects of care delivery are shared that
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
My clinical week was emotional and physically draining this week. I enjoyed being the lead on Thursday because it gave me the opportunity to stop and observe. The nurses and the CNAs were very stressed out, and I clearly saw the effect on the patients. For instance, one of the CNAs asked me to help her with an occupied bed change. I was excited. However, she kept passing a bunch of comments of how hard nursing is and how she did not want to be old. I did not acknowledge any of her comments. Perhaps she thought she could express herself (as a result of her stress) in front the patient since the patient was non verbal and could not understand. I felt very bad. I was very uncomfortable and sad. For me, it doesn’t matter whether the patient
The world loves to see great organizations that are known for their achievement and meeting their goals and putting smiles on other people/patients faces. Healthy work environments make sure that they show each other great communication with whatever they do inside the workplace. It is a good thing for all workers inside of any workplace of health to practice speaking to each other during procedures and especially during any breaks. This together forms special bonds and chemistry. When there is great chemistry between workers, they feel way more comfortable with the decisions and are less likely to make bad decisions or make mistakes because of not feeling like they are doing the right thing. All of this is just a more broad way of saying collaborative relationships, and promote decision making among all nurses is so important. Uncomfortable workers will always feel that they cannot do anything on their own. So most of the time when they do not feel like they can do something on their own they would normally try and leave to get assistance from another worker or just act very hesitant. No patient wants assistance from a worker that doesn’t feel comfortable. So that is why workers should communicate with each other, and not want to feel bothered. Workers would then learn to freely go around and keep the place clean. Sweeping, sanitizing, and being very precautious is what people love to see when stepping in because unhealthy work environments can have adverse consequences on the quality of care delivered as well as nurses intention to leave the profession. Workers wouldn’t want to work in a profession that has an unhealthy work environment because they are just as careful with other people’s lives just as they are with theirs. Unhealthy work environments aren’t the right places to perform work in either. They are not the right places to perform procedures or not
Clinical Orientation was the concept of the week. Knowing what’s the importance of Hand washing or hang hygiene and knowing how to execute it well was the topic during the simulation day. It is about preventing to chain of infection from nurses to patients, family, friends and to the public. So nurses having a knowledge on how to execute hand washing properly makes the nurse to be aware of their own hygiene and the nurse would be able to provide individualised hygiene care. (Crisp et all, 2013) Knowing your way around to the hospital and knowing hand hygiene was the main focus of the clinical orientation.