I am writing a synopsis for my Emergency Department (E.D.) observation day. I was assigned to a soft-spoken intelligent nurse that had a giving and a sweet disposition. We were assigned a total of five patients, of which four we introduced ourselves and assessed. It is not that the day was slow, but my nurse was assigned to go to the front of the E.D. at 11:00 to work at the registration desk. The hospital has placed registered nurses at the registration desk to obtain the initial assessment of patients entering the E.R. doors to determine the priority and level of treatment needed. The first patient of the morning was a female that presented with a recent diagnosis of swollen salivary glands and she thought she was having an allergic reaction to the antibiotics she started taking yesterday; or she wondered if she was just swollen from her recent diagnosis and that’s what was causing dyspnea and shortness of breath. Intermittently Respiratory administered an albuterol treatment and we performed vital signs, assessed her and listened to her lungs with our stethoscopes (before breathing treatment), which was unnecessary for the fact that we could hear that she had stridor from standing across the room. As the nurse was documenting the patient’s vital signs, she made the comment under her breath that the protocol for the E.D. when someone comes in for shortness of breath, is to obtain an electrocardiogram (ECG), but she continued to say how the Nurse Practioner (N.P.) on
During this day, I was assigned to care to one of our sick residents and based on my assessment, her condition shows no sign of improvement from her chest infection so I checked her vital signs specifically her respirations. After assessing her, we rang in the GP to inform him about the condition of his patient and asked him to schedule a visit. Also, in the afternoon, we had a new admission from Eversley. Firstly, we greeted the patient, introduced ourselves and oriented the resident to the unit. Secondly, the nurse from Eversley informed us about the relevant information about the patient’s
The main key issues in case #5 is that the MMG system had not achieved its overall financial performance goals; therefore they experienced a big loss secondly the transition of new leadership became an issue. The difficulties of implementing the MBS business model in the Hospitals and Clinics division also became a very important issue. Having to come up with a strategy to improve the financial side and being able to focus on customers and relationships was not an easy task for them. Hospitals had a different approach of helping customers in
Could you imagine working as a EMT and not knowing what could happen at anytime that you are on the job. As you can tell this job is in very high demand, people are in need of people to run emergency vehicles. Emergency Medical Technicians have been in need since the 1960s, Emergency Medical Technicians have to go through extensive training and meet education requirements to be able to do this job. There are many different things that Emergency Medical Technicians do while on the job, there are also very many levels to being an Emergency Medical Technicians.
S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.
This assignment will reflect on the effectiveness of my clinical and interpersonal skills in relation to my position as a nurse in a busy critical care unit. It will primarily focus on one particular patient and the care they received by myself in their immediate post operative period. In accordance with the NMC’s code of professional conduct names will not be used to protect the patient’s confidentiality. NMC (2008).
There was additional backup staff present (including a respiratory therapist) that could have been called upon for help, yet they never were. The charge nurse or nurse supervisor could have stepped in at this point to provide additional help. A lack of present nursing staff and support can lead to unfavorable patient outcomes, as is the case with Mr. B. Additionally, the staff on duty could have lacked training regarding protocols or their training could have been out of date.
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to
Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.
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
The overall results are presented as a qualitative analysis and it allowed the researchers the opportunity to produce new inputs.
This chapter provides an overview that describes the basic types of hazards threatening the United States and provides definitions for some basic terms such as hazards, emergencies, and disasters. The chapter also provides a brief history of emergency management in the federal government and a general description of the current emergency management system—including the basic functions performed by local emergency managers. The chapter concludes with a discussion of the all-hazards approach and its implications for local emergency management.
The patient went as far to admit that she currently is having a hard time breathing, but has an appointment with her gynecologist on Monday. This writer advised the patient that if she has difficulties breathing she will need to go to the ER immediately and be medically assessed by Nursing. The patient started crying about she does not want to be medically assessed as she needs to return her boyfriend vehicle so that he can work. This writer informed the patient about the seriousness of her health comes first. This writer called Nursing Chrystal, but no response. Then this writer and the patient went to the Nursing Director office to be medically assessed. According to the Nursing Director, she advised the patient to go to the ER first and will not be dosed today unless she provides proof of documentations of her visit. Again, the patient fussed and then says, " I am fine, it's not serious," however, the patient was advised to follow medical
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.
In “Wither the Emergency Manager,” Niel R. Britton comments on Drabek's “Human Responses to disaster: An Inventory of Sociological Findings.” Britton describes six positive and negative issues in emergency management as it is today. In this paper, we will discuss the implications on emergency management as a field and on the individual manager.
Flashing red and blue lights accompanied by an alarming siren in the distance is signaled when the double doors of the emergency room burst open. Pushed by several nurses, doctors, and other medical staff, a lone hospital stretcher with a bloody, wounded patient flies through the medical center towards the doors to the operating room. This image is what generally comes to mind when you think about an emergency room. Many people believe that the hospital’s emergency room is a dark and scary place. While this is true, the common misconception is that the emergency room is a place clear of humor, when in reality humor is present, even necessary, for many reasons. Many television shows, like the show ER, are based in the setting of the