Entering The Emergency Room

Stress causes people to make unnecessary mistakes; but these types of mistakes are about life or death. Several recent studies

Nearing the end of my shift in the Emergency Department, I was requested to accompany a patient while the nurse readied the discharge papers. Upon entering the bay, I met a very small and fragile patient who was anxious to go home. Conflicted between my primary duties and responsibilities to complete training for two inexperienced volunteers, I decided to put forth my interests in teaching by demonstrating compassionate care to my trainees. Although the patient repeatedly refused my assistance, I gave my best effort to calm her as I cloaked a warm blanket around her. As I listened to her confide in me of all of her hospital anxieties, I was shocked from the lack of quality care she had received which made her feel more sick after the first

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

The practice problem that this writer chose was psychiatric patients that are boarding in the emergency room that do not have a therapeutic environment. The website that this writer chose to use to research about the non-therapeutic environments for the psychiatric patients that are boarding in the emergency room is CINAHL complete. From this search of boarding psychiatric patient in the emergency room, eleven articles resulted. Boarding of psychiatric is all too common of an occurrence in the emergency room because of the decrease in inpatient psychiatric hospital beds. There has been a decreased in beds over the years in 1990 there was “3.7 beds per 1000 person” and in 2006, it decreased to “2.6 beds” (Nolan, Fee, Cooper, Rankin, & Blegen, 2015, p. 57). All of the article that were resulted from

We know that he had sustained an at home fall. We learn that he has a history of pain and a prescription for oxycodone for back pain. We know that his vital signs on admission appear stable; he was not showing any signs of respiratory distress. As we look at the staff that was listed that day we do get the sense the hospital may have been short staffed. Staffing report shows there was one MD, one RN and one LPN managing at least 4 patients including- one patient was a child. Evidence based research has proven that the nurse to patient ratio is directly related to the patient outcomes (Stanton, 2004). It is important that we consider the staffing level that this rural ED as we know short staffing can be blamed for not being able to take the full amount of time needed to do a proper health history. A detailed health history is an imperative part of the care process; it is used by the staff to accurately assess any acute changes that may take place in the patient throughout their stay.

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

The overall results are presented as a qualitative analysis and it allowed the researchers the opportunity to produce new inputs.

For my mentor project, I chose to shadow Dr. Kristen James, D.O., a young emergency room Physician (approximately 33-34) who works in the E.R. at Tenova North Knoxville Medical Center. The length of all emergency room shifts are twelve hours—7:00 a.m. to 7:00 p.m., 7:00 p.m. to 7:00 a.m., or 11:00 a.m. to 11:00 p.m.— but for the sake of the well being of my mind and body, I only shadowed for a half of a shift (11:00 a.m. to 5:00 p.m.). I had previously shadowed my father in the same emergency room for a twelve hour shift and I knew that I definitely did not have the stamina to make it through another one with a clear mind or comfortable feet. During this essay, I will be tying in some useful comparisons between shadowing my father vs. shadowing

Miscommunication and missed information, resulting in potential errors, have been on the rise at Pelham Medical Center. In the past, the primary nursing staff was giving verbal report to oncoming nurses at the nursing stations. There are many disadvantages to this practice. Verbal report at the nursing station is distracting with so many nurses talking at the same time and is frequently interrupted by other staff, call bells, and family members. There are also potential HIPPA violations when reporting on patients within earshot of other people who are not involved in that patient’s care. The patients and their family members or care

is very pleased with the quality of care she recived during her stay, after further conversation with her I noticed a couple of things that would have improved the quality of care. there was a dicrepancy in the care she received in two different units. while in delivery unit all the call bells were answered on time and the nurses checked on her frequently, same couldn't be said about the nursing care in the recovery unit. A couple of incidences stood out that could have been handeled in a different manner. First one was that when S.D. received her meal and she wanted to confirm that it was a vegetarian meal. The nurse said that she was sure the meal ddn't have any meat in it because that’s what her chart said. but this response didn't satisfy the ptient and she decided not to eat the meal. Second incident was more of a safety concern compared to the first one. S.D. was advised to call for help before going to the bathroom because of pain and swelling around her stiches. But during one instnace while she rang the bell, a nurse came in and told the patient that because her husband was sleeping in the room he could help her to get to the bathroom. This incidence raises a serious safety concern for the pateint. If an untrained healthcare professional such as her husband helped her get in and out of the bed, he could have pulled on the stiches and caused a potential

On august 13, 2016 I was assigned to follow one of the ICU Nurse. It was a very calm day. She had two patient one was more critical than the other. Both patients were on the ventilator because they had to be intubated the night before. The lady is obese and had gastric bypass surgery two years ago and suffering from severe sleep apnea, but the patient is non-compliance to the CPAP treatment. That was her second time being intubated. She was admitted for seizure monitoring because she was constantly having seizures the day before while she was at home. Due to the fact that she did not want to wear her CPAP machine while in the hospital, after pain medication was administered she was found unresponsive, that was the reason for her intubation the night before. Patient was on intermittent suctioning, she has sinus tachycardia . I had the opportunity to observe some of her daily care. The patient was on fentanyl but when the Dr. try to wean her out of the ventilator she stop breathing, therefore, the DR. discontinue the fentanyl temporarily in other to retest her later.

From my experience volunteering in the emergency department at my county’s largest healthcare provider, Union Hospital, I recognize the medical issues,

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

Flashing red and blue lights accompanied by an alarming siren in the distance is signaled when the double doors of the emergency room burst open. Pushed by several nurses, doctors, and other medical staff, a lone hospital stretcher with a bloody, wounded patient flies through the medical center towards the doors to the operating room. This image is what generally comes to mind when you think about an emergency room. Many people believe that the hospital’s emergency room is a dark and scary place. While this is true, the common misconception is that the emergency room is a place clear of humor, when in reality humor is present, even necessary, for many reasons. Many television shows, like the show ER, are based in the setting of the