A Interview About An Hour After This Incident

When I arrive to the facility this morning I was informed that one of the patients had passed away during the night, which was quite sad. Today I was in the acute ward all day and was able to watch the RN perform an ECG on a man that was bought in via ambulance who was complaining of chest pain. I watched as she placed the ECG leads on different positions of the chest. The RN showed me what a normal heart rate should look like. I also went around the ward taking OBS and notice that one of the patient's O2 levels were very low at 73%, the RN then gave the patient some ventolin through a mask to increase oxygen levels and they rose to 95%. The RN also showed me the medication charts and how they are to be read. I went around with her watching

Patient satisfaction is a big nursing-sensitive indicator that has a lot of room for improvement within this patient scenario. Patient satisfaction can also refer to patient’s family satisfaction in most cases because they are both the customer. The certified nursing assistant taking care of Mr. J could have approached the daughters concerns in a more appropriate and professional manner. She could have begun by validating the daughters concerns followed by notifying the RN, who in turn could have implemented certain interventions to prevent further harm. Honesty and better communication could have resulted in improved patient satisfaction in the last part of this scenario. If the staff would have been honest with Mr. J’s daughter by communicating the mistake and given her an action plan as to what they are going to do in order to never allow this to happen again, she may not have complained to the hospital administration. Nursing can improve patient safety and outcomes by better understanding and incorporating nursing-sensitive indicators such as restraint prevalence,

MICU 15A was dispatched to 30 West Ave, @ Genesis Healthcare, Wayne Center in the Wayne Business District in Radnor Township, for an ALS Emergency, Assault Victim. The weather conditions were cloudy, cool and dry. MICU 15A responded with care per protocol to the stated location with EMT Straub driving. On arrival, the EMS Crew proceeded to the nurse's station, and the individuals there did not know anything about an incident, there was a female standing in one of the hallways who advised that there was a person sitting over where she was. The EMS crew proceeded to that area and found a 43-year old female who was a registered nurse and was conscious and alert x4 and was sitting on a chair, the EMS crew asked her what was happening, "she replied that she was in a patient room and stated that the patient had an IV in her arm and became disturbed and picked up a pocketbook and then assaulted her by the swing it and striking her in the right frontal region of the head", the nurse then exited the room and went and sat down in the hallway, where the EMS crew found her.

I never faced a situation like that before. I really did not know how I could help this man. The staff and the doctor at this point were relying on my help as a chaplain. At that moment for the first time I realized how important my role as a chaplain was.

was scheduled to work day security on my very last day of work and we got a call about a climber that had fallen off of Palisade Head. Now to get a little perspective on how serious this actually was, Palisade head is approximately 300 ft. from the ground at its peak. So, we rushed from the park up to Palisade head and we were met with a rush of frantic people and a scene I necessarily was not prepared for. I was left on the top of Palisade backing people away and clearing the scene while the lead Security Ranger for the day took off full speed down to the bottom to assist with medical. He promptly assisted others with CPR for about 25 minutes until local law enforcement and EMT arrived. The gentleman that fell got lucky only suffering a

My charge nurse informed me that my assignment was to care for an increased intracranial pressure new admission patient. The gentleman was in his early thirties and he came in thought the hospital emergency department after wrecking his motorcycle. This patient was immediately transferred up to my intensive care unit and had family present. I went into the room to get report and my patient’s father constantly interrupted the day shift nurse. He frantically asked what was happening, if there was any hope of survival, and if he should have his son’s care transferred to another hospital. This was all the overwhelming information that happened in the first five minutes of the first portion of my simulation. The second portion of my simulation was on advanced cardiac life support. Though completing the critical care simulation, I learned a major strength and weakness I have as a senior nursing student.

Monday, August 1st, 2016 at approximately 2:10 p.m., a follow-up interview was conducted by Detective L. Donegain withy Dana Dudley at the Police Department. Dana Dudley admitted to knowing the person who committed the shooting at the Tobacco Mart. Dana Dudley stated he was Anthony Smith’s residence with Jamarqus Hurley playing video games. Dana Dudley stated he Anthony Smith and Jamarqus Hurley walked to the Tobacco Mart to purchase a drink and cigarettes. Dana Dudley stated while they were standing at the night service window a vehicle backed into a parking spot in-front of them. Dana Dudley stated Jamarqus Hurley looked at the vehicle and recognized the driver as the person who had shot “POP” Hurley’s nephew. Dana Dudley stated Hurley then

Mrs. B was a patient I treated on my last day of placement. She has a long gamma nail inserted to her femur after diagnosed with left neck of femur fracture. We had an extremely busy start in the morning. My supervisor and I both had a look on her folder and admission information before going in. We understood she is NESB. Luckily, we found a nursing student could be an interpreter. My supervisor asked her to stay because we were about to sit the patient in the chair. We went up to the patient, explained what and why we were going to do. My supervisor left the ward while I was handling the cords, leaving me with the nursing student and the patient. He did not return after 2 minutes of waiting. I attempted to ask the patient to move her legs across the bed. She moved her unoperant leg and I moved her operant leg, I paused when I noticed she started grimacing. She slide forward and her body was in a half-leaning back position.

A time when I had a client fallen out of bed and there was a client who wanted her PRN medication. I was in the client's room assessing him and making sure he is okay and there was another client who kept on calling for her PRN pain medication. Since the fall requires immediate attention and is more serious, I told the Personal Support Worker to go and tell the other client that I will get to her as soon as I am done with this client. The client agreed to wait for few more minutes. I ensured the fallen client is okay and safe back on his bed before I went to take care of the other client. I prioritized what is most important and what required immediate attention.

Then I received a new admit with telemetry I had to give that patient away to get this new telemetry patient. This patient was from skilled nursing facility (SNF). The patient was being admitted with pneumonia and sepsis. When received patient from the emergency room, who had multiple wounds to whole body. Literally it took me and certified nurse’s aides one hour take pictures, due to patient being confused and combative with us. It was fourteen hundred (1400) not gone to lunch. The charge nurse could not help me or watch my patients, was busy with transferring patients to another facility. And we did not have a break relief nurse. Hospital was already short staff of nurses. They called nurses come in, but unfortunately no one came. With having high acuity patients’, not enough nursing staff, and having exposure to this stress over time leads to nursing burnout. With the Affordable Care Act the health care has experienced an increase in the number of new patients’ in the emergency room. Some of these patients that are coming into the emergency rooms have chronic illnesses that were ignored and now require more care. Due to increase in patients the wait times and patient loads have also increased for nurses and

My first on-call shift was Sunday, May 20 from 1200 to 1800. I received a call that there was a victim of rape at IMC around 1700 that day. I jumped in my car as fast as I could to head up to the hospital. Right as I was pulling into the parking lot, the nurse called again and told me that the patient changed her mind and did not want a rape kit to be collected. I was slightly frustrated, but I had to respect the client’s wishes. I did not receive another call in the next hour.

I have asked the administrator if she could get me numbers about turn over rates, the average death rate, and the average pay rate of a resident that lives here. To start of the Glenwood has a very high turnover rate, it is said that they have 3 employees quit every 3 months, which means they lose an employee at least once a month. This is due to there being no benefits and the average pay rate for a CNA here is 9.75, an RA gets paid 9.25, thus it is hard to keep good employees with low pay and low incentives, resulting in a high turnover rate here. Paige S, states that the average CNA’s pay rate is $11.56, it also says that the pay rate will change according to location and the amount of care given at the facility. The overall average time a person will stay and work in a place like this is only 21 months, which is very low, and it is due to the same reasons that I have stated above. However the work here is not too difficult because most of the residents are able to do everyday tasks, they are usually there for emergencies, and to help pass medications for the people that are not able to do it for

However, he continued to curse at us and even tried spitting at nurse. The nurse continued to inform him that in order to fully assess him, so that we could see the extent of injuries and treat him, we needed him to calm down. As I was pulling the gown out to ask him to change, he ripped the gown from my hands. Before I knew it, he had it tied around the nurse’s neck, choking him. I immediately called out for help; meanwhile the nurse was able to get out of the choke hold, and the police were there soon after to help contain him. In the end, the nurse nor the patient were seriously injured. The nurse went on to finish his shift and a report was filed. After a few days, I was talking to the nurse and asked him what was done about the incident to which he replied, “Nothing, there is nothing we can do, we do run the incident up the chain, but nothing will be done, it is just part of what we do here.”

Upon my arrival with the Westmont Ambulance Squad, I was met by the Manager, Michael Costello. He related that an employee identified as Jose Santiago fell three feet to the concrete ground from a frame striating machine. Mr. Santiago was located in the shop on the floor as described in a semi-conscious state and was being attended to by EMS. Mr. Santiago works daily on the machine and reportedly lost his footing causing the fall. The victim was transported to Our Lady of Lourdes by Westmont Ambulance for further treatment. Notification to Mr. Santiago’s family was made by Mr. Costello. No

An older woman in her 60s came in complaining of stomach pain. Donna was the one taking care of her, and when she went in to get vitals, she said I should probably stay in the nurses station because the lady wasn’t very friendly. That was probably a first indicator. I don’t know the specifics of what was wrong with her, but I knew she was really sick and needed treatment. She started getting antsy though, and wanted to leave. She kept trying to pull out her IV so Donna asked one of the nurses to stay in her room and sit with her to make sure she didn’t pull it out. Shortly after there was screaming. The woman was yelling that she refused treatment and demanded she leave. Donna went in for backup while I stayed and watched from a distance. Her daughter had dropped her off and left to go home and take care of her baby, so even if she wanted to leave she couldn’t. The yelling continued until Donna came out and explained the situation to the doctor. He said that they had to section-21 her so she could not leave the hospital, then Donna called a Code 22, which means there is a violent patient and calls all available staff to come help. They called the nursing manager and most of the nurses. They restrained her and were able to put an IV back in her arm. It sounds a bit cruel but without treatment the woman probably would have gotten even worse. All the nurses looked quite stressed out after that, and on top of that the other man was screaming