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During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

During my clinical competency placement, I was working on a surgical ward when a registered nurse on duty asked me to assist Mr. A with his shower. This incident happened on the fifth day of my clinical practice. He was a dementia patient and had undergone right knee total joint replacement. She also informed me that the patient did not like too many people in his room because of his dementia. When I went into his room, his wife was there with him. I talked to the patient about having a shower and getting dressed to look smart and he agreed to have a shower. The patient got out of the bed and walked to the bathroom and sat on the shower chair to have his shower. Then I asked his wife if I needs to stay with him to assist with shower, she said she can help him as she was taking care for him at home since he has been diagnosed with dementia. Therefore, I left the patient with his wife to help with his shower and told her to ring the bell if she needs any help. After some time I left the room, the wife rang the bell. As soon as I entered the room, I heard him shouting at his wife and she started crying and left the hospital. So I had to stay with him. He was very capable of washing himself and I just had to help him wash his back as he requested. After he had washed, I asked him if he was ready to get out of the bath, he started shouting at me.

The patient was located on the fifth floor and as I was bringing them down the elevator, there was a family member of a patient in the elevator. Under HIPAA regulations, I cannot allow others to view the patient confidential information that I had in my hand. As we got to our stop I told the patient to follow me through the mechanical doors. I told the patient to wait in cubical 2 and that the nurse will be with then in a few moments. In addition, I will be getting them a warm blanket once I come back. I headed to leave the binder at the receptionist desk in the OR where they had another patient pick-up waiting for me. Before I left, I went to get the patient a warm blanket from the storage area that had temperature control. I gave it to the patient and left. Ronnie saw me and asked me if I did the patient pick-up alone, I said yes and he was surprised. Usually he needed to teach others in order to know what exactly they had to do. The only reason why I knew that I had to do everything that I did was because Ronnie told me everything verbally. He did not have to show me what to

She immediately started to worry and stated “What excuse can I give you so you leave me alone?” I responded that we just needed to get ready for the day and we did not even need to call it therapy. Once she sat up she started hyperventilating. My supervisor was in the room at the time and said this was exactly what would happen the last time she stayed in the TCU. After 45 minutes, lots of encouragement, rest breaks and maximum assistance we finally got her dressed and situated in her recliner. While I was documenting the patient was talking to the nurse about how she did not want to have therapy anymore. The nurse responded to the patient and asked her why she was in the TCU if she did not want therapy. In the same week, this patient declined therapy all together and both physical therapy and occupational therapy had to discharge

We arrived at Clearview at 2231 Hrs. and took the patient to room 14. I went back outside and began to put our unit back together when Supervisor Carlock approached me and in a very agitated voice said: “WHY DID YOU PULL OFF?” Surprised, I said “What are you talking about?” He said loudly, “I TOLD YOU TO STOP AND YOU DIDN’T!” I replied, “Jeff was telling me not to stop because we had a pulse back.” He said “I DON’T CARE WHAT JEFF SAID, I’M YOUR SUPERVISOR AND I TOLD YOU TO STOP!” I said “Dennis, I think you’re talking to the wrong person, you need to be talking to Jeff, I was doing what he told me to do.” He replied “WHO’S YOUR SUPERVISOR, WHO’S YOUR SUPERVISOR, I AM, NOT JEFF, YOU DO WHAT I SAY!” I said ”yes, you are the supervisor, but at that moment I was doing what the Paramedic in charge of patient care was telling me to do, and what I felt was best for the Pt., since we had a 41 Y/O patient who had a pulse.” He said “I DON’T CARE, YOU DO WHAT I SAY!

Whilst on duty on a general ward I was asked by my senior nurse, if I could go down to the pharmacy to pick up some new medication for a new client, who would be needing them at lunch time. On my way to get them, I was approached by another health care assistant who requested my help with a client, who was lying in their own faeces. I therefore felt that the medication could wait, and that my main

One of the paramedics massaged Candee’s hands as she breathed. Once they had her calm I answered questions from one of the paramedic regarding the cause. I told them I was in contact with her husband providing updates and I asked if she was going to be taken to hospital. The paramedic stated they did not want to take her for an anxiety attack and asked me if her husband could come and pick her up. I called the husband and he stated 30 – 45 minutes ETA and I relayed that to the paramedics. They were ok with staying with her until her husband showed up. The paramedics and Candee walked to the conference room, a short distance down the hallway, to wait it out and I stayed closed by in the lunch room, across the hallway, to make myself available while providing privacy. After about 25 minutes one of the paramedics informed me that Candee requested to be taken to the hospital and that they have no choice but to take her when she makes a demand. The paramedic said that her husband could follow them there and that Candee was in communication with her husband on her cell phone. They were taking her to Kaiser Oakland as Candee was on the phone while they wheeled her out the

This is where the question came in that is not the protocol, why are you doing the extra step so I explained my reasoning which was wrote down. The next patient, after I had made my area clean decided that he needed his blanket right at that time. The patient proceeded to removing his arm for my clean area, as far as I know he may have touch a contaminated surface therefore before cannulation I used alcohol again. My nurse educator asked me again the question, I gave her my reason and my reason was wrote down. As a CCHT I know I am not allowed to go outside protocol without strict agreeance of the charge nurses, even on such a small infarction, due to my actions ride on the charge nurses licensure. I was called into the office and due to bring forth holes in the procedure that was not contemplated when written, my administrator and nurse manager expressed their appreciation on my work and reminded me of my certification. I found this a test of my courage, I could have completed the job according to policy then I would have not had been

Upon arriving at Hays Medical Center, my classmates and I met on the third floor for preconference. I grabbed a computer and logged into my client’s chart to see if there were any new orders. I had no new orders. In conference, we were to give report on our patient. My client was a young male in for a bowel resection due to an obstruction. After giving report, I met up with my senior two, Brendell. We proceeded down to the acute floor. I found my client’s room and waited for report from my nurse. I went ahead and introduced myself to my patient and explained to him that I would be helping today, that if he needed anything he should hesitate to ask. I went forward with my bedside assessment, making sure to do everything

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.

Patricia Benner is known as one of the most recognized theorist of our time. Patricia born in 1955 in Hampton, Virginia spent most of her childhood in California. It was there that she received her professional education. This paper will focus on her Novice to Expert theory using the Model of Skill Acquisition through defining concepts within her conceptual framework, identifying assumptions within her theory, discussing the significance of her theory as it relates to advanced practice nursing, and addressing how applicable her theory is to actual nursing practice.

The nurse kept answering Patient B that they needed her bed because she was no longer telemetry monitored and the bed was required to monitor another cardiac patient. Patient B, thinking that she was the first patient in that room and Patient A is no longer telemetry monitored also, responded by asking why can 't Patient A be move instead. The nurse abruptly replied, "Due to the possibility of Patient A having C-diff, we have to move you as a precautionary measure." This explanation occurred within the earshot of Patient A. Patient A became visibly upset and tearful, and vocalized that she believes her rights to privacy of her medical condition were violated. Patient B was moved to another room within the same unit. Subsequently, Patient A asked for another nurse to be assigned to her. However, to add fuel to the flame, in the process of providing bedside report to the replacement nurse, the outgoing nurse mentioned Patient A 's new cancer diagnosis in front of Patient A 's family. The patient, once again became visibly upset and tearful because she hadn 't had the chance to talk to her family about her terminal cancer diagnosis after speaking with her physician earlier that morning. On several occasions, the patient complained about her privacy being violated and threatened to file a lawsuit against the nurse and QMC for violating her rights. Subsequently, the charge nurse, nursing supervisor and floor manager were notified of the

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

Description: I have been working on the night shift in our ward. Upon arrival from the nurses station at around 2130 and received a handover, the evening nurse then left at around 2145. The handover was brief and basic; also it tackles all the important points that I need to know about the patients. After receiving handover from the outgoing nurse, I also received a ward handover as an in charge for the night shift. After completing the ward handover, I started with my initial rounds into one of my patients. The infusion pump was making a “downstream occlusion” noise, prior to that during handover, I heard a beeping sounds coming from one of the rooms in our ward but we ignored it. When I pointed the torch into the pump and examined the IV lines, I noticed that the administration rate of total parenteral nutrition or TPN rate seemed to be different from what was handed over to me. To make sure that the rate is correct or incorrect, I shuffled through the bedside notes. I looked for the TPN chart and found that the TPN bag had been changed at around 1700 with a different rate. It was more than four hours after the TPN bag was hung and administered at an incorrect rate.

She was met by the nurse who got her checked in and into a gown. The nurse made sure to thoroughly explain everything that was going to happen, to the patient. The nurse attached the monitors, got vitals, reviewed her medical history, and had the patient sign a form for consent. She then started her IV, and took blood for labs. They did some shave prep where the incision was going to be done. She was not in labor, so the cervix did not need to be checked. SCD’s were applied but not hooked up to the pump. My patient was started on Lactated Ringers as well as 2 grams of Ancef for the GBS. The patient was accompanied by her significant other (the baby’s father.) My patients partner did not appear to be very supportive. He didn’t pay much attention to what was going on. When it was time to take her back to the operating room, he refused to come back with her. Even after informing the partner that the patient was very upset and crying in the OR, he still refused to be with her.