Evaluating Interpersonal Communication

The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’

Lack of situation awareness by the nurse and failure to use the SBAR protocol when on the phone to the cardiologists.

Additionally, the care environment developed a hazard when the patient population increased both in number and acuity with the admission of the acute respiratory distress patient and increasing patient load in the lobby without note of available back up staff being called in. Examples of errors from the flow chart comparison might include failure to assess and monitor when Nurse J initiates blood pressure and SpO2 measurements, fails to initiate ECG with respiration monitoring, fails to administer supplemental O2, and leaves the room without apparently noting the baseline of the patient2. Furthermore, there appears to be an error in the lack of communication collaboration between the RN and LPN regarding Mr. B’s post procedure status and monitoring needs, and there is a failure to rescue when the LPN notes the low SpO2 value, fails to respond, and instead re-initiates another blood pressure reading without noting the results. As Mr. B’s condition deteriorates and a code is called, an ACLS error is observed in the timeline when the patient is noted first to have absent pulse and respirations and that a monitor is next applied and the patient and displays ventricular fibrillation. Chest compressions appear to not have been the first action in this scenario, nor is end tidal CO2 monitoring noted as initiated to monitor the quality of compressions. These are examples of hazards and errors in the care of Mr. B and in an actual RCA the level of detail would likely turn up

This essay sets out to discuss the importance of comprehensive and accurate assessment on a registered nurses’ ability to make excellent clinical decisions. It will examine what factors can change a nurses’ capability to be aware of, and act on abnormal assessment findings. As well as assessment being part of the nursing process that is used in every day nursing, it is also a critical part of patient safety (Higgins, 2008). Assessment findings are used to determine what needs to be done for the patient next. Early warning scoring systems currently exist to aid in the early detection of patient deterioration (Goldhill, 2005). The rationale for the use of these systems is that early recognition of deterioration in the vital signs of a

a. The LPN was engaged in caring for the emergency transport patient along with the RN and was also in the process of discharging the other two patients. 3. Why did the LPN not notify the RN of the alarm and reading? a. With the information provided, it appears that the LPN was distracted as well as did not follow her scope of practice.

I then went and found another student who had not seen a PCA pump before and with the patient’s and family’s permission we had a learning opportunity. The patient’s daughter was knowledgeable about the PCA pump and explained to me and another student what was running and at what rate and how often the nurses change the syringe. And also upon our assessment what she said matched. She also stated that two nurses had to come in and change the medication since it was morphine and both of them had to sign on the computer. Being adamant and respectful while effectively communicating to the team are of uttermost importance as a charge nurse. This is because during report some students wanted to finish their paper work before the report or try to rush the report but respectfully I had to insist on the need of a getting a report, which is where I had the greatest

At 3 am while the aide had her sleep brake, the patient’s husband called her to help him patient back to because the patient fell out of the bed during her sleep. As per aide, there were no visible injuries and the patient and her husband refused to call 911. Patient‘s PCP notified and patient’s children as well. RN visits scheduled for post fall

For instance, 58% of out-of-hospital personnel and 51% of emergency physicians verbalized that they would refrain from resuscitating a patient found in cardiac arrest with a POLST patient specifying do not resuscitate (DNR) and full medical treatment (pp. 259–260). Unless the physician adds defibrillation and CPR medications in the additional order section of the POLST, no patient with a DNR status should ever be resuscitated. Under those circumstances, it’s up to us as professional nurses to question any physician who orders defibrillation and the administration of CPR medications to a patient with a DNR status. Frighteningly, according to Moore et al., the TRIAD studies illustrated no improvement in the consistency of POLST form interpretation among either out-of-hospital personnel or emergency physicians who had received educational POLST training (pp. 259–260). This example reinforces what Mary Beth stated in the PowerPoint presentation: having a reliable and emotionally intelligent proxy who can serve as a durable power of attorney for healthcare (DPA-HC), can help guide healthcare professionals through the gray areas of decision-making. In other words, making the patient’s preferences known and advocating for these choices to take

Witnessing the communication among the: interdisciplinary team, HCP, Nurse Practitioners, Lab technicians, and others was great. Every time the patient or family member requested to speak to the HCP, my nurse would page the HCP through the computer and the HCP would be calling or showing up to the patient’s bedside. If my nurse questioned an order and began to be concerned, she would contact the HCP, and await confirmation by the HCP to provide reassurance regarding any concern. As a nurse, you provide comfort and answer any question the patient asks to relieve their anxiety. My nurse did an exemplary job. Every question the patient or family member had, she answered it with the correct information and eased their concerns. My communication style impacted in my own way during my assessment. I was able to communicate with the patient and ask the reason he was admitted into the hospital. At first, he was startled as to why I was doing my assessment and the questions I asked towards him. He then began to be more outspoken as I gained his trust. I believe that all the organized foundation the interdisciplinary team offers facilitates the quality of care toward the patient. I believe there’s always room for improvement. As for myself, and my own professional self-development, I believe I can improve in being more confident when I ask questions towards my patients. All in

“My role here, on the unit is to make sure that the nurses and patients are satisfied. I do this by making sure that there is a significant amount of staff to attend to the patients, that all patients’ needs are met, and to make sure everything runs smoothly for the staff, all supplies are readily available at all times.” “I also handle grievances for both patient and staff, we here at Toresdale (Aria Health), want to make sure that the patients are taking care of here to our best abilities. That is why it is imperative for the nurse’s on the floor to be properly prepared. That being said, our staff on this floor is a mixed group when it comes to experience and

We are living in an era where technology has dominated every major industry. According to our class lecture, (Chamberlain College of Nursing, 2015) every nurse should have the basic computer knowledge and skills so that he or she can access information swiftly and proficiently. In retrospect, to the reading of both text and lesson, it is quite vivid in my mind of the experience that I had with this patient. It was my turn to receive the next admission from the Emergency Room. Initial report given to me was that this 48 year old white male by the name of Mr. M came via Ambulance complaining for Chest Pressure. Vital signs completed as follows: BP 108/62, HR 103, RR27, and oral Temp 97.9 done by EMT reroute. He is a construction worker

The high acuity of patients in the ICU makes the risks of patient harm higher. Patients have decreased physiological reserves, so any harmful events become exponentially worse as compared to more stable patients. Therefore, reporting changes of a patient’s condition is a vital part of ensuring the rendering of proper care. When nurses fail to report critical lab values and vital signs in a timely manner, the patient can suffer long-term effects or may even die.

Upon arrival to the unit, there were 2 nurses running down the 7-side hallway. The majority of staff members were gathered at the front desk. I saw Michael, SWAT RN enter the unit. I walked down the hallway to receive report when I was immediately asked to print out lab labels and zebra labels by SWAT. Respiratory Therapy was also looking for the primary overnight nurse or charge nurse to assist with obtaining an ABG. I offered my assistance because the patient looked terrible and was clearly fighting the needle sticks, which was putting both RT and SWAT in danger. I then realized this was my patient, only after looking at the assignment once blood work was sent off. During the chaos, I was told by the primary overnight nurse that she would fill me in when I was “ready” and that she had charting to do. The overnight nurse for this patient never once re-entered the room during this emergency at change of shift. The patient decompensated quickly and was escalated from NRB mask to bipap. Work of breathing worsened, anesthesia was called and MICU resident came to bedside to assess patient. During this time, the charge nurse stated that I needed to get report on all my patients. At this time, around 0800, I told primary nurse that she should be the one calling over report due to the fact that I still hadn’t even received a summarized report on this

My responsibility was to find a balanced solution that meets the goals of previous steps and communicates that decision. My decision was to ask the assigned nurse to

As a Nurse, I believe that effective patient communication is integral to competent patient care. The patient to nurse communication sets the tone for the patient’s stay and how they are going to feel about the care they receive. It furthermore improves their care because patients are often quite knowledgeable about their bodies. Just a few months ago, I cared for a patient with medical device I was unfamiliar with. My unit had a nurse call out, and our patient to nurse ratio was higher than usual. I did not stop to research my patient’s notes as I usually do. Typically, when I have a patient with an unfamiliar medication, device, or condition, I have them explain it to me in their own words and I research it myself. On this day however, I decided to “go through the motions” and try to get a head start on my busy day. I attempted to get started on my assessments and medication pass as soon as possible. My patient had what is known as a left ventricular assist device. A surgical device worn by patients with severe heart failure in need of a heart transplant. The night nurse had already informed me that the patient had some extremely liable blood pressure readings overnight, but not to worry, it was normal for the patient as she needed a heart transplant. The patient care tech brought me the vital sign sheet. Wow! Blood pressure 60/40? “This cannot be accurate at all” I thought to myself. I decided to assess this patient first, considering her blood pressure reading was so