Presidencial Case Study

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 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).

If the physician continued to be dissatisfied later in the week and felt that I was now the problem, I would begin by letting the physician know what has been done up to that point to address his original concern. Next, I would apologize that he feels the way he does. Moreover, I would make sure that the director of ambulatory care, my direct supervisor, is aware of the physician’s complaints so they can appropriately investigate and address

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 facts of this case are that Dr. Guiles who is self-conscious of his prostate cancer diagnosis is treated horrendously when he finally decides to have surgery ( Buchbinder, Shanks & Buchbinder, 2014). Considering that Dr. Guiles is already sensitive about his condition, his unbearable symptoms are not helping matters (Buchbinder et al, 2014). Upon arrival at the hospital, he is treated subpar. The admitting clerk is rude and unbecoming to a patient who isn’t feeling well and who is embarrassed about his sickness (Buchbinder et al., 2014). To make matters worse, he has to find his own way up to the floor by walking, which causes him to be even later in checking in because of the need to stop frequently to urinate as well as having difficulty in walking (Buchbinder et al., 2014). Once he arrives on the floor, the charge nurse is not welcoming and unprofessional (Buchbinder et al., 2014). After figuring out what to do with the paperwork; and the nurse aide delivers Dr. Guiles to his room, the nurse aide does not offer to help settle him in (Buchbinder et al., 2014). Therefore, Dr. Guiles is faced with battling obnoxious family members who are on his bed and to make matters worse someone is in the bathroom which doesn’t help his need of having to frequently urinate (Buchbinder et al., 2014). When the issues are brought up to the charge nurse, the charge nurse accuses Dr. Guiles of wanting preferential treatment

3) Surgeon: Was directly involved in the events leading up to the sentinel event. The surgeon was responsible for all activities taking place in the surgical suite and directly related to the surgery of the pediatric patient. The surgery was completed safely and successfully; however, the surgeon had relevant information in the patient chart at his office yet did not share this information with the hospital. He also did not supply an appropriate or accurate H&P that would have included custodial status for the pediatric patient to the hospital. The surgeon is greatly concerned in the events that lead to the sentinel event and wants to ensure that his patients will be cared for and safe at Nightingale Community Hospital.

1. The physician in this video went against the patient's wishes. The nurses in the clip followed the physician's orders and participated in the resuscitation. What professional roles and/or attributes that we discussed in class did they ignore and how should they have responded in this situation? Describe specific examples of professional communication techniques they could have used.

According to FindLaw (2008), Ellen H. Finnerty, a registered nurse is requesting the Board of Nursing in Texas to set aside the judgment where she was disciplined for gross negligence and incompetence. The board’s decision came after an incident where Finnerty chose not to comply with a physician’s order to intubate a patient before said patient was transferred to the ICU. In August 2002, Finnerty was working at Huntington Memorial Hospital as a charge nurse. A nurse (A. Magi) that was caring for patient(J.C.) begin to display symptoms of respiratory distress, such as rapid and labored respirations of 40 and an oxygen saturation of only 70%. With the assistance of a respiratory therapist, the patient was suctioned and Nurse Magi received orders from the primary care physician for 100% oxygen via a nonrebreather mask with the oxygen saturation to be maintained above 94%, several different blood test, for the administration of a diuretic. After the orders were performed and the patient was continually monitored, there were no changes to the respiratory rate. Another call was placed to the PCP, there was an order given for the patient to be transferred to the ICU and stat intubation. These orders were relayed to Finnerty, who then assessed the patient, but did not disclose her findings with the medical staff. Lab results indicated that insuffient blood oxygenation and acidosis. The

Evaluation is the third stage of Gibbs model of reflection and requires me to state what was good and bad about the event. While reflecting back on the incident I felt that there was one thing which I could have dealt with differently and also some aspects which demonstrated good practice. On the first hand, this incident made me realised that I was part of the team and that I was also involved in positioning and preparing the patient prior to surgery, therefore I had a responsibility to find out from the patient if he had any concerns. On the other hand, I should have communicated to the patient, explaining what I was about to do maybe he would have had the opportunity to raise his problem with the shoulder before lifting his arm. The Health Professions Council (HPC 2008) clearly states that it is the responsibility of an operating department practitioner to ensure that effective communication occurs when delivering patient care. In addition, Psychologist Helmreich, R. (2000) said, `better communication’ is being the most useful way of reducing errors.

The scenario was alarming yet gave a realistic view on how non-adherence of procedure, breakdown of communication and the lack of accountability became the triggers for this sentinel event. Since 1996 the Joint Commission as instituted a sentinel event policy that enables hospitals to evaluate and implement corrective action that will reduce future risk (Sentinel Event Policy and Procedures, 2014). My role as the medical student was significant to the outcome because I was medical aware of abnormal changes however not confident enough in my abilities to be an advocate for the patient. Evidence of the patient status through data trending would have provided the support I need to contact the attending physician. The inability to follow proper hospital procedure related to aseptic techniques was the first of many problems.

Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to wait few minutes after

Then I was off for two days at work. When I returned, I found out that this patient is improving and has been transferred to medical surgical floor. I went to see her at the medical surgical floor before the start of my shift. I noticed that patient conditioned has improved and I introduced myself and told her I wanted to make sure that she was alright before starting my shift. I asked if she wanted to talk to me about this visit. She thanked me for providing great care and discussed about her event. I listened attentively. She further said that she has been stressed a lot these days and drinks excessive alcohol to recover her stress because everyone around her are dying. She is not paying attention to her health lately. But with this incident

In the health care system, a multitude of errors occurs on a daily basis. Doctors, nurses, orderly’s, etc., everyone in health care settings has responsibilities that warrant careful attention. This was exhibited in the case study titled ‘An Extended Stay’. In this case study, we are introduced to a middle-aged man in his 60s named Mr. Stanley Londborg. He presented with several health conditions, including a seizure disorder, hypertension (also known as high blood pressure), and Chronic Obstructive Pulmonary Disease (COPD). Londborg was no stranger to the hospital and was known fairly well by faculty members. Londborg paid a visit to the Emergency Room at the hospital complaining of wheezing and breathing complications. The physician that examined Mr. Londborg yielded his symptoms as an acute worsening of

Compliment/Complaint/Grievance: Patient presented in ED w/ c/o left eye blindness. During his ED visit patient complains nursing staff was rude, non-communicative and no one answered the call light until after 2 hours. He indicates blood work was drawn twice totaling 9 vials of blood work obtained, and no one informed him the reason for the blood draws. He went to CT-Scan of the brain, and was not made aware of the results until Dr. Sinclair visit today. He also indicated Dr. Masse, came in to evaluate him after hours of waiting, informed him he was going to read the CT-Scan results and come be back to discuss in further details. The MD never returned to discuss the CT-Scan results with patient. Patient states his call light was on for

Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.