Patient Scenario
Daring my second semester I met a geriatric patient, The patient was a seventy-eight year old male. His medical diagnosis was dementia, anxiety, congestive heart failure, and benign prostatic hyperplasia (BPH). This gentleman’s BPH resulted in acute urinary retention which has symptoms of inability to urinate, painful urgent need to urinate, pain or discomfort in the lower abdomen, bloating of the lower abdomen.
To access for BPH one asks the patient about difficulty in starting or continuing urination, reduced force or weak stream, sensation of incomplete bladder emptying, straining to begin urination, post void dribbling or leaking (Ignatavicius & Workman, 2013, p. 1630). The nurse I was working with explained that do to the patients underlying health issues he was not a surgical candidate, and that to help the patient void he had an indwelling foley catheter placed long-term.
One of the nursing duties assigned to the nurse I worked with was to change the folly catheter. As part of my head to toe assessment that day I had already validated that the foley catheter was patent and draining. The nurse explained that the catheters were changed on a thirty-day schedule for any patient with a long-term indwelling folly catheter. The nurse explained to me
Collaboration is a complex process that requires intentional knowledge sharing and joint responsibility for patient care. Sometimes it occurs within long-term relationships between health professionals. Within long-term relationships, collaboration has a developmental trajectory that evolves over time as team members leave or join the group and/or organization structures change. On other occasions, collaboration between nurses and physicians may involve fleeting encounters in patient arenas (Lindeke PhD RN, CNP, & Sieckert, BAN,
It is obvious that a great deal of interprofessional research has been aimed to educate practitioners and nurses over the past decade for interprofessional practice (Orchard, King, Khalil & Beezina, 2012). The Institute of Medicine (IOM) “The Future of Nursing Leading Change, Advancing Health” (2010) recommend that private and public organizations, nursing programs and associations increase opportunities for nurses to lead and manage collaborative teams. Health care reform has created a shift in the healthcare delivery to place more emphasis on interprofessional health care teams (Sinfield, Donoghue, Horobi & Anderson, 2012). New implications are directed towards continuing education for health care workers to understand the meaning of interprofessional collaboration to support the changes in collaborative practice to improve patient outcomes (Orchard et.al, 2012). Encouraging health care professional to collaborate as a team more effectively may seem as the answer to improve the quality of care, but ineffective communication from team members to collaborate on the care needs often attributed to patient safety issues. Consequently, even when professional collaborative teams work together, there is no means to validate and measure the impact on continuing education for nurses about interprofessional collaborative practice (Sinfield, et al., 2012).
Different studies had different result numbers or different percentage reduction rates which was primarily based on their indifferences in regards to study design utilized and sample size. As evidenced by research results (Magers, June 2013) and (Welden, 2013), these showed a reduction of urinary catheter days resulted in reduced CAUTI rates. Though different outcome results between the different research studies, they all strongly significantly supported the notion that a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter compared with a no protocol is essential to help in the reduction of CAUTIs. Interpreting these results, (Meddings et al., 2013) showed a drop greater than 52% in CAUTIs and a decrease in catheterization by 37%. The study results from the six scholarly research study articles showed nearly similar or corresponding outcomes. The results were significant enough to support the PICO question. In general, though the difference in sample size, the results still strongly supported excellent outcomes when a nurse-driven protocol is used to evaluate the necessity of continued urethral catheter use. (Chen et al., 2013, para.
The patient, LL, is a twenty four year old female who was diagnosed with obsessive-compulsive disorder five years ago. Around the ago of eighteen, LL started to experience many symptoms of obsessive-compulsive disorder. She had just started her freshman year at a local college and moved into the dorms with a random roommate. LL was constantly washing her hands and grossed out by the germs, so she came to realize she had a phobia of germs. She would begin sweating and having major anxiety when people went to shake her hand or her roommate would touch her food or any of her things. LL started skipping class and isolating herself in her room in order to avoid contact with other people. When her grades dramatically declined,
Ignatavicius, D.D. & Workman, M.L.(2010). Medical-Surgical Nursing: Patient-Centered Collaborative Care. (6th ed.). St. Philadelphia PA: Saunders Elsevier
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
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.
After further multidisciplinary team meetings with the involvement of John the treatment option of automated peritoneal dialysis was implemented (NSF 2004). Once the Tenchkoff catheter had been inserted, education and training completed John was ready for discharge home.
Upon examination, a proper medical diagnosis was able to be made. According to the clients urinary and blood re...
In this section the researchers explain the complications that can occur based on non-adherence to a proper self-catheterization regimen. A spinal cord injury can cause an interruption in neural pathways which affect the function of the bladder causing urinary incontinence, urinary retention, urinary reflux, and recurrent urinary tract infections. These problems can ultimately lead to an increase in renal morbidity and mortality (Shaw & Logan, 2013) Later, in the discussion section of the article, the authors focus on the importance of nursing education to teach patients proper methods to perform and cope with ISC in order to eliminate these common occurrences in patients suffering from SCIs (Shaw & Logan, 2013). The perception of performing this task may vary from patient to patient. This research helps identify various educational approaches that could be taken to accommodate all patients. Therefore, the research is significant to nursing due to the fact that nurses are considered the primary educators and are expected to address practical issues with patients performing ISC and help them manage the psychological issues that are faced with this
Working in the health care setting, teamwork and collaboration are used frequently to insure that everything runs correctly and efficiently. According to qsen.org, teamwork and collaboration consists of functioning effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care. While assessing the patient a nurse can come into contact and work with many different individuals. These can include other nurses, doctors, therapists, and family
As an advanced practice nurse (APN), one must interact with other medical professionals cooperatively and collaboratively to ensure the best outcomes for his or her patient population. Interprofessional collaboration happens when providers, patients, families, and communities work together to produce optimal patient outcomes (Interprofessional Education Collaborative Expert Panel, 2011). This type of teamwork and cooperation ensures that all of the providers caring for a patient act in a cohesive manner in which everyone including the patient plays a role in the management of the individual’s health. The purpose of this discussion is to evaluate interprofessional practice and provide the view of a
As a medical / surgical RN, I provided care for the elderly, the infirm, the mentally challenged, the young, and the psychologically disturbed. The wide variety of patients exposed me to the effects of life style choices, health care choices, and the resulting impacts to the patient as well as to the family of the patient. This experience has fully matured my view of the awesome responsibility that we, as health care professionals, have been charged with, and it has furthered my desire to obtain the skills necessary to provide more advanced care for my patients. In addition to exposure, maturity and experience, my career as a medical / surgical RN has also sharpened my critical thinking abilities and provided insight on observing signs and symptoms that a patient may be unware of. Furthermore, as a charge nurse I learned the importance of collaborating with other health care professionals in order to provide the highest level of care available. In summary, my career as an RN has provided valuable experience, maturity, exposure to impact and outcome, enhanced my critical thinking abilities, and improved my collaboration
Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.
Collaboration is the foundation to success in any team. In the healthcare setting, interprofessional collaboration (IC) has been a significant trademark among numerous highly successful innovations. Collaboration between nurses and other healthcare providers improves the quality of care, coordination, and communication between the team leading to increased patient safety. Working in a team to achieve common goals implies open communication, respect for others, mutual trust, and honesty. The purpose of this paper is to discuss the meaning of interprofessional collaboration, its implications for practice, describe the role of IC in the provision of patient and family-centered care,
Friendships may be formed; however, having professional interactions is something that is not always followed. In terms of patient confidentiality, we may not realize that a HIPPA violation has occurred due to a friendly conversation with coworkers. If a patient were to overhear their nurse discussing their information in an unprofessional manner, then it may cause issues with a patient’s dignity and their rights. If a patient’s right is violated, then it can lead to a patient’s mistrust in their caregiver, leading to mistrust in the facilities, and can end with a patient’s health being compromised. The patient is the reason for this career; if the needs of the patient are being unmet or violated then the purpose of our occupation will be unsuccessful and indifferent.