Lack Of Team Work Between Doctors And Nursing Staff

A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have

The charge nurse met the writer in her room and stated, "I am so glad to see you but, you have a "fresh heart" tonight.  The assignment was clearly outlined during bedside report.  But this writer quickly pointed out that she had not been heart trained and could not accept the "fresh heart".  The charge nurse validated the assignment by informing this writer that staffing was really short and she felt this writer was the most qualified nurse for the job.  The charge nurse also added, she would be available for any issues, should they arise. Logically, as the charge nurse had explained the scenario, the assignment was delegated correctly according to the available staff.  But for this writer, it was  morally wrong for her to accept the "fresh heart" knowing she was not following the outlined protocol.  Also, by caring for the "fresh heart" a question was raised if it was the safest thing for this writer to accept.  The ANA Code of Ethics Provision 4.3 states nurses are responsible for assessing their own competency within practice (P475 ethics).   Since this writer had previously validated her competency and training with the devices and medication being utilized in caring for the "fresh heart", she did not violate The Code of Ethics.   Additionally, Provision 4.3 states nurses are to accept or reject assignments based on the nurses knowledge and competence, as well as their assessment of the level of risk for patient safety (Para 1 p475).    The ethical principal of nonmaleficence could have been an issue had there had been any harm committed to the patient  by this writer. This writer knew she could have rightfully rejected the assignment due to safety concerns, but did not.   Legally, this writer did nothing wrong in caring and monitoring for the "fresh heart"

In the Code of Ethics for Nurses provision 4 states “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.” This was not done, there was no regard for human life. The patients in the hospital were treated as a burden. A meeting was held where the doctors agreed that

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

The two provisions from the Nursing Code of Ethics that were violated are Provision 2 and 3. Provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population” (Brown, Lachman & Swanson, 2015). Provision 2 focuses on “the nurse’s obligation to assure the primacy of the patient’s interests regardless of conflicts that arise between clinicians or patient and family”(Brown, Lachman & Swanson, 2015). Provision 2 was violated because the nurses

If testing results support the suspicions of impairment, then management is mandated to report the incident to the North Carolina Board of Nursing (NCBON, 2011). With increased medication errors, Beverly failed to provide a safe and effective nursing care to the patient, therefore violating the laws of the Nurse Practice Act (NCBON, 2009).

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for

Management needs to empower nurses to speak when they feel there is a safety issue

Interprofessional team collaboration for professional nurses is viewed as a method to improve the care and safety for patients. However, interprofessional team collaboration presents both advantages and challenges for nurses and other team members. One of the advantages is the coordination of care for the patient and the sharing of knowledge to improve the outcomes for the patient. Challenges for interprofessional team collaboration is: poor role-definition, miscommunication, conflict, lack of accountability for assignment of responsibilities and tasks (Reeves, 2012). This paper will discussion the role of a nurse on an interprofessional team and the challenges, why interprofessional teams promote patient safety, and strategies to promote success interprofessional teams.

There are errors and hazards in care that occurred in the Mr. B scenario. One error was the emergency room physician’s failure to recognize the signs and symptoms of deep vein thrombosis (DVT) that Mr. B was presenting. If not treated early, a DVT can become a pulmonary embolism, a fatal condition that Mr. B unfortunately developed. Another error in care that happened in the Mr. B scenario is the nurses’ failure to monitor Mr. B’s ECG and respirations. Early detection of critical ECG and respiratory changes could have initiated medical interventions that would have saved Mr. B’s life. One hazard is the emergency room nurses’ heavy patient load at the time of Mr. B’s sentinel event. Another hazard is having a licensed

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.

The nurse stated that the IV was discontinued and there wasn’t a need to call the IV team (patient is a difficult stick) to start a new IV because the patient had no IV medications prescribe and he was due for discharge that morning. However, the morning doctor came and prescribe a Lasix IV push for the patient due to 2+ edema in his bilateral lower extremities. My preceptor made a nursing judgement not to call the IV team to start an IV line, but instead to call the doctor to prescribe an alternative route for the medication. The doctor was not available and my preceptor left a message causing a delay in the administration of the patient’s medication.

I would agree in that, not everyone will get along with each other, however, and if we are not able to set our own feeling aside that it will affect the quality of nursing care that, we provide to patients and how our fellow co-worker view us a professional. Great post, thanks for sharing.

The Reason Model which was initially proposed by James Reason, now generally and frequently referred to as the Swiss Cheese Model, a system that basically evaluates and understands what an incident or accident is, to which every step of the process has its own potential failures. The Swiss Cheese Model works on an assumption that most accidents can be tracked and followed back to one or more of five levels of failure, concentrating on the organizational influences and human limitations (UNSW 2011).