Hospital Repeaters Analysis

This episode of care occurred in a community setting. Sara has a diagnosis of Alzheimer's disease. She live alone, has no children and is a diabetic. Sara does not speak English and her first language is Polish. Sara support worker developed a close relationship with Sara but said recently her dementia as gotten wrong and she sometimes does not remember who she is. Sara has cellulitis on her legs and was refusing to let the support worker change her dressing. She kept saying it was ok and she didn't want it to be changed. The student nurse and the district nurse tried reassuring Sara and explaining why it was importance to treat her leg but she just became more agitated and aggressive. The district nurse and support worker knew it was important

The nurses did not act as sentries towards the patient or the family. They did not protect the patient’s choice to die in peace, instead they just let the doctor jump in into the situation and try to resuscitate her even though she did not want that.The nurses should have stepped in and asked the frazzled husband what he wants the nurses and doctor to do. Not let the doctor yell at him until he is forced to allow it.

An experienced nurse Julie Thao was taking care of 16-yeas old Jasmine Gant who was about t give a birth. Thao is accused of making a mistake that had terrible and tragic result on the life of a pregnant teenage, unborn child, Gant’s family, health care, and Thao’s life. Thao mistakenly gave Gant an epidural anesthetic intravenously instead of an IV antibiotic for a strep infection. Within minutes of receiving the epidural IV, Gant suffered seizures and died. Her child, a boy, was delivered by emergency Caesarean section and survived. So what caused this tragedy to happen? According to investigation, Thao improperly removed the epidural bag from a locked storage system without authorization, she did not scan the bar code, which would have told

This writer escorted the patient to Nursing Coordinator Kesley office as the Nursing Supervisor was not in her office. Upon entering Kesley office, Kesley was having a discussion with another nurse and this writer apologized for the intrusion. This writer addressed to the Nursing Coordinator that the patient is experiencing bedbeg and the patient is aware he will not be dose by the Nursing window, only curbside. It appeared that Nursing Coordinator was being abrasive towards the patient as she explained to the patient as to what is needed before the patient can reenter the clinic. The patient then became agitated and shouted at Kesley and says, " Kiss my Ass, " and then proceeded storm out into the lobby area.

Castillo kept acting in belligerent manner and stating that he was going to leave. I, Steven Evans then spoke to him about the fact that he appeared to be intoxicated and that he could not leave at this time. I reiterated to him that any attempts at leaving would not work and he could possibly end up being restrained by medical staff with Security assistance. The patient did not like what I said to him, so he threatened to leave and then proceeded to step out of his room. Security Officer Alonso and I asked him twice to go back to his bed, at which time he became unreceptive and refusing to go back to his room. Officer Alonso and I had to physically and forcefully direct him back to his bed. Once on the bed, he became physically aggressive and attempted to hit Officer Alonso. We instantly took control of the patient's arms and upper body while Security Officers Paz and Weiland controlled his legs as he kept screaming and fighting with us. Nurse Baptiste proceeded to contact the patient's Doctor Cleveland so that a sedative could be given to him. At 0020 hours Nurse Baptiste walked into the room to administer a sedative to Mr. Castillo. The patient fervently refused and Security had to physically hold the patient down during the

University Hospital is a well known hospital with a level 1 trauma treatment center for the tri-county area of a northwestern state, the hospital enjoys the fact they are known for their promising reputation among healthcare professionals and the public they serve. Jan Adams is an OR supervisor that has been working there for ten years, as a professional she makes surgeons follow protocol as required and enjoys working with trauma patients. One Friday night, which is the busiest day of the week for the trauma department; the unit was notified that a helicopter was on its way with a 42 year old man who had been in a car accident. Shortly after the patient arrived to the trauma center, the resident and other medical staff noted that he was in very bad physical conditions, needed immediate surgery or otherwise he was going to die. The issue was that the on call surgeon had to be present during the surgery and had not yet arrived, but regardless of the matter and protocol they proceeded with medically treating the patient immediately. The concern is that in doing so they violated medical procedures and put the patients safety at risk, this lead to a long list of ethical issues for example, patient well-being, impaired healthcare professional, adherence to professional codes of ethical conduct, adherence to the organization’s mission statement, ethical standards, and values statements, management’s role and responsibility, failure

I had my first two night shift this week on Sunday 9/13 and Wednesday 9/16. I am on 7 West at Sharp Memorial Hospital and the unit is PCU unit with tele monitoring. The unit had a high census this week, but proper staffing and no codes lead to the nights being relatively calm. I was working with Laura who is not my regular preceptor. She stepped in to work with me for this week while Elle, my regular preceptor, was on vacation. I had a wide variety of patients on my two shifts. The first shift I had a patient that was suffering from an exacerbation of COPD with a history of CHF and a patient that had polycystic kidney disease, which had progressed to end stage renal failure. The second shift I had four patients; one patient had been admitted to the hospital multiple times in the past month for GI bleeds, another patient with a history of diabetes and hypertension was admitted for fever and chills and was later diagnosed with sepsis, the next patient had a history of schizophrenia and was found on the ground in her home and was expected to have been there for over 24 hours resulting in deep tissue injury, and my final patient was suspected to have a history of alcoholism and presented to the hospital with shortness of breath and an oxygen saturation of 89%. The first clinical shift I was shadowing my nurse for a majority of the shift. I was being orientated to the unit and learning where to find supplies on the unit. The second shift I took a

In a hospital I worked at recently, I was told in report that a patient I was taking was demented and didn’t know where she was or what her situation was. The patient admitted for a post knee replacement was 86 years of age, fragile, very hard of hearing and mute. The pain in her knee was excruciating and she often cried out asking for pain medication. Moving her in the bed also caused her pain, because she was said to have dementia no one explained to her what they were doing so, she fought the staff when they moved her or changed her brief. After I came on shift I assessed her, I attempted to take her knee immobilizer off to assess her knee and she cried out in pain and smacked my hand aside. I felt so bad for her, I decided to try to yell

On Friday 06/10/2016 at approximately 2007 hours, Security Officers Omar Alonso (420) and Michael Chin (223) along with Supervisor Steven Evans (407), were dispatched for a (53D) Disorderly Patient in Medical Unit, room #2139. Security staff arrived at 2008 hours and made contact with RN Andres Flores, who stated the patient, Janet Riggs (DOB: 8/21/1965) had gotten out of bed and attempted to leave. Mrs. Riggs is an Altered Mental Status (AMS) patient and had been very combative with medical staff and family members. She had attempted early in the day to injure herself and bite medical staff. Security conferred with nursing staff and it was decided that the patient would be placed in 4 points restraints to stop her from harming herself and

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.

The first category was the compliant patients that understood the staff was there to help them. It seemed that no matter how sick they were, they were always happy to see the nurse or doctor because it meant they were checking up on them and had their best interests in mind. The other category of patients was those that were did not want to be there. They were very ungrateful, pessimistic, and rude to the doctors and nurses. Every time the nurse came to tell them they were going to run a different test or do some physical therapy, they cursed and complained the entire time. Due to their unpleasant nature, I quickly noticed that the nurses would only enter these rooms if they had to. I didn’t appear that the nurses were intentionally doing this, I believe they would rather spend their time helping those who truly appreciated what they were doing. After meeting with several patients, I began to realize the body language and communication changed with each patient. Some patients loved having my company and enjoyed telling stories and having someone to listen to them. There was almost an immediate change in their demeanor when I walked into their room, because they knew I was there to visit with them. They would turn and sit-up in their bed or they would move to their chair so they could sit and visit. Whereas, other individuals were very reluctant to talk

About 2:30 in the afternoon, M.E. was in her patient’s room and J.P. confronted her in front of the respiratory staff and students that were present about why she was/wasn’t doing certain things and what was making her so slow; J.P. caught M.E. off guard and was very abrasive, belittling and verbally abusive; M.E. felt attacked and embarrassed, especially since this behavior took place in front of colleagues. J.P. felt frustrated that M.E. was not more competent and efficient in her care and confronted her about it. After the confrontation, there were no words spoken between the two of them for days and even though months have passed, there is still an obvious tension and unresolved conflict between these two individuals. There is currently a noticeable effort being put forth by both women but the conflict they experienced is not yet fixed.

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.

Small patient groups within the wards, along with large community meetings, there feelings are shared and patients' comments taken seriously, and work assignments, recreational activities, are assigned to make the hospital less like a "holding" environment. .

On a daily basis there is a lot of thought and focus directed at these patients to assure they are getting quality medical care; you may have caught a medication error, made multiple phone calls, waited on hold for what seems like forever, waited on doctors, ran to another floor all to get a patient something they needed or wanted, or may the nurse noticed an important change in the patients status that could dramatically affect their outcome. Most times the patient does not see or not even know about these behind the scenes battles to ensure quality care. Conversely, most often, especially when considering a patient in the hospital setting, our perception is our reality. Patients often do not know the ins and outs of procedure and protocol and rely solely on their perception of the care they are receiving. Studies have shown that patients desire to be perceived and cared for as individuals. Lying in that bed waiting on a nurse for 20 minutes for pain medication may just translate into lack of care on the nurses’ part to the patient but in reality the nurse was caught in another room with a different patient with a situation he or she couldn’t walk away from. Often nurses are stressed which can also convey a certain harshness to patients. In other cases maybe the job has become so repetitive that the nurse