Radical Mastectomy: A Case Study

As human being we all think, feel, behave and perceive life in different ways as we all have different expectations. Conflict is part of life and it can be part of any situation. Especially in nursing field where working as a team is highly emphasized, every member of the team collaborate together in order to meet patient needs and improve patient outcomes. That being said, nurses have to collaborate with coworkers that have different social groups, ethnic, and educational backgrounds. This paper will give a synapsis about a disagreement that happens between a register nurse (RN) and a license practice nurse (LPN) in a forty bed medical surgical unit with sufficient staff coverage with RNs LPNs and UAPs. As the manager of this unit, while

As nurses we accept the responsibility of caring for the patient therefore, we have to be hold accountable for the care that we provide. It is important for nurses to use their own judgement in accepting responsibility, when to seek consultation and when and what to delegate to others. According to Battie & Steelam (2014), “a prospective nurse should hold themselves accountable for patient advocacy, continuity of care, lifelong learning, to colleagues, the nursing profession, and their organization”.

Resolution of conflict in a timely and positive manner under strong leadership is crucial to provide safe and effective patient care while encouraging therapeutic relationships among interdisciplinary healthcare teams.

Analyzing case study 16, multiple patients with peripheral vascular disease need to be delegated to staff on a vascular surgery unit depending on the care and responsibilities that each patient requires. The RN team leader has the authority to delegate tasks and will distribute the workload according to each staff member’s position, scope of practice, education and experience. Another factor to consider before delegating is that the RN team leader should consider the following: risk for harm, complexity of task involved, and level of patient interaction involved.

Growing up in a small rural community in Jamaica I had a real life view of an area on the forefront of poverty with limited access to proper and affordable healthcare. Twelve years ago I can recall watching my cousin slowly declined from being a joyous mother and friend to a torpid corpse that deteriorated from breast cancer. Despite all the help and effort to sustain her life with the little resources available, she died nine months later even after having a double mastectomy and chemotherapy. The cancer had metastasize long before she was diagnosed. Losing her was devastating, especially on her husband and two children. Her death and as well as other experiences contributed to my appreciation physicians and other health care workers.

It can be hard for nursing students to apply theoretical knowledge to clinical setting without some proper guidance and support. This paper will discuss a critical incident which occurred in Week 3 of my N308 clinical course. The incident was related to skilled communication and organized prioritization, which are topics covered in N307 seminar. From a nursing perspective, this incident made me realize the importance of effective communication, prioritisation, and management skills because disorganized care would pose a threat to patient’s safety and compliance with the fundamental principles listed in the CNA code of ethics (Canadian Nurses Association, 2017).

Registered nurses are the primary caregiver to the patient, they enhance the safety and care of the patient. Registered nurses put together the data collected by other nurse in order to maximize the good health status of the patient (Weydt, 2010). The challenges faced by nurses lead to delegation of duties so that there will be clinical influence and financial outcome. The delegation has been one of the most effective, challenging skills that is practiced by nurses. The registered nurse has to understand the need of the patient and family members making sure the appropriate nurse is delegated to the for patient care better outcome (Weydt, 2010). The purpose of delegation, challenges faced and how and when to delegate duties will be discussed.

Adaption or innovation styles from a charge nurse needs to create a work environment that satisfies all parties concerned (Huber, 2013). Two possible solutions that can alter how this patient scenario plays out is bargaining or negotiating. Bargaining, by having the charge nurse and unlicensed assistive personal (UAP) work collaboratively to prepare the patient for her surgery eliminates the male nurse from the patient. This gives the charge nurse insight to receive reflective responses from the male nurse to explore his feelings in relation to his assignment. The other solution is negotiating, not only with the male nurse but the patient as well. By asking the patient if she would mind having a male nurse be part of her care, while using this as a learning process to educate the new male nurse to his role on the unit gives the charge nurse the opportunity to implement active listening technique to experience what the patient needs, why she is nonverbal and understand what additional training the unit needs, not only the male

Nurses must be able to learn from each other, their seniors, and even patients on how to enhance the quality of care they provide. Through teaching and learning, nurses will understand that individual patients have varied preferences, values, needs, and respond well to different kinds of medication. In addition, continuous teaching and learning processes will enable nurses to know that individual patients experience varied side effects of the same prescribed medicines (Davis, Schoenbaum & Audet, 2005). Thus, nurses will understand the importance of consulting with individual patients while providing health care services to patients, and that illuminates the significance of patient-centered care in the U.S. health care system. As nurses a huge part of our duty is teaching the patient and our teaching cannot be effective if our communication is not the best, therefore we need to change the way we communicate in order for our patients to understand. Efficiency in health care services can as well be attained through proper communication. Other than communicating with fellow medical professionals in medical facilities while providing care to patients, nurses are directly obliged to communicate with their patients to find out their values and preferences when making clinical decisions. Essentially, consultation with patients, which is a major component of patient-centered care, is necessary

As professional nurses we have obligations to both the patient and the medical community. Nursing is not only a trade developed through formal education, but also through the interactions we have in practice which are equally if not even more important in development. Each Patient has the right to the best possible care regardless of race, religion, sexual orientation, socioeconomic status, beliefs, or previous decisions. Nurses should strive to build therapeutic relationships that will benefit the client and leave a lasting impression. We have a duty to play several roles including educator, supporter, listener, and advocate. The professional nurse should be an active member of the interdisciplinary team contributing to knowledge, growth, and a respectful atmosphere. Most importantly, each patient deserves a nurse that is part of a healthcare team focused on obtaining their ideals of health and preserving their privacy, sense of safety, dignity, and human

The primary barrier impeding effective interaction among the personnel is a communication barrier. Information exchanges between the patient’s primary care provider and other care providers are often where errors occur or where information is lost. Two-way communication between the surgeon’s office and the hospital is necessary for effective and efficient patient care. Consequently, there does not appear to be an effective channel of communication with the surgeon’s office to obtain appropriate documentation which would have included the patient’s custodial information. Secondly, the pre-op nurse was in an emotionally charged situation due to the stress of an increased workload and additional responsibilities. Although, the appropriate

for which the nurse has accepted responsibility. When the nurse delegates it is important to

A review of the records reveals the member to be an adult female with a birth date of 04/20/1977. The member has a diagnosis of pain following reconstruction for prophylactic bilateral mastectomies. The member’s treating provider, David Janssen, MD recommended the member undergo bilateral breast implant exchange/internal Lewis procedure.

Safety of the patients’ care is the identified issue, in reference to lack of communication. All disengaged patients should be accounted at all times. The staff responsible for the patient should be on alert about possible issues that may occur relating to that particular patient. For example if a nurse is taking care of a dementia patient that is a risk for elopement there should be procedures in place to prevent issues. The hospital needs to have procedures in place for checks and balances for each possible safety problems that may arise. The risk management will have to create written procedures for check off between staff. Tina’s mother instructed pre-op nurse to call her in the event that surgery was out sooner than expected. The pre-op nurse should have passed information to intraoperative nurse to call Tina’s mother. The follow up information should be documented in the patient’s chart.

collaborate and work together. Effective, safe and high quality care can only be provided if good communication and collaboration exist between nurses, providers, patients and also their