What will you do to handle the emergent situation

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Reference no: EM133751589

Problem

You are a new RN, working on staff for 8 months now on a busy 25 bed medical-surgical unit in a large metro hospital. Today the unit is staffed with 1 charge RN (who does not have any assigned patients), five RNs assigned 5 patients each, and two CNAs. Here are the issues of the day for you to handle at the beginning of your shift:

Your 5 patients include:

1) A 55 year-old male patient who is one day post-op a major abdominal surgery. This patient is still NPO, and has a naso-gastric tube attached to suction. Report this am states he required two doses of pain med during night, and is awake now and beginning to complain of pain again. Will require bed-bath, and abdominal wound care.

2) A 60-year old female with history of Type II diabetes, poorly managed, and gangrene in left foot. She is going to surgery for a left BKA at 10 am. She and her family are very anxious about the surgery and "what is going to happen now."

3) A 63-year-old female with history of COPD who was admitted yesterday with pneumonia. Shift report stated he has been having a lot of shortness of breath all night, and diminished lung sounds. He slept with head of bed elevated.

4) A 45 year-old male who has been in hospital now for 4 days, after an MVA. He had a right pneumothorax from fractured ribs on right side and has a chest tube, attached to a pleurovac, and multiple bruises on right side. He slept through the night with less complaints of pain then yesterday, and has been getting up to bedside commode and bedside chair.

5) A 26 year-old female due to discharge today who has a history of severe asthma and was admitted two days ago with respiratory distress

A. One of the other RNs on duty "teases you" (according to her; you see it as being made fun of) about being new and still not knowing what to do, how to work efficiently.

B. The charge nurse tells all of you that the CNAs cannot complete all of the care; you have to decide which tasks to delegate.

So your questions for you to address for this exercise, that requires you to think about many of the concepts discussed this semester:

A. For your 5 patients, you need to decide how you can use teamwork and collaboration among all of you to make sure you each get through the day. All of the RNs have complex assignments, like you.

B. You need to decide who to assess first this morning.

C. If your patient with COPD and pneumonia develops respiratory distress, how will you recognize this, and what will you do to handle this emergent situation?

D. What process should the surgical team use when your patient goes to surgery for the left BKA-and why?

E. Using clinical judgment and patient-centered care-briefly describe what actions you need to carry out during your shift for all of your patients.

F. Using Evidence-Based Practice, determine why your post-op. patient has an NG tube to suction, and when will he get to have this removed? When will he get to eat?

G. Using conflict management strategies and professionalism, how can you handle the coworker who is "teasing" you?

H. Using delegation, and clinical judgment, decide what tasks to delegate to CNAs.

I. What do you need to do to deliver ethical practice, and keep from committing negligence?

Reference no: EM133751589

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