A nurse’s aid who is also a second year nursing student at university saw the client , took his blood pressure which was found to be elevated at 185/112. His heart rate was rapid at 113 beats per minute. The clinical picture indicated that the man was most probably having a heart attack. The student / nurse called an ambulance. As per unit protocol an accident/incident form was filled. Chest pain is a common occurrence with older patients. In the Emergency Department, chest pain needs to be isolated as cardiac or non-cardiac in origin. Physical assessment and proper history taking is very important in identifying the type of chest pain the patient is experiencing. This will also help the health care provider prioritize the plan of care. Proper assessment and history taking through detailed interview could have helped greatly in avoiding errors and reducing incidence reporting. This also indicates that the quality of care is improving. Pain is a very subjective matter. McCaffrey defined pain as whatever the person experiencing pain says it is, existing whenever the person communicates or demonstrates it does (McCaffrey, 1986). Chest pain is one of the most common complaints in emergency departments of hospitals and acute care centers, so common that immediate evaluation and correct diagnosis is very important in the patient’s survival. The situation describes a 44 year old Anglo-Saxon male client presenting with crushing chest pain. History shows long term use of alcohol, obesity, diabetic with insulin infusion, diaphoresis and shortness of breath. The Registered Nurse who first assessed the patient missed critical information such as taking the vital signs of the patient. Vital signs, particularly blood pressure is very important in the assessment of pain. Increased blood pressure usually indicates severe pain (Cox). High blood pressure and tachycardia are symptoms of a heart attack. These symptoms plus the crushing chest pain, diaphoresis and shortness of breath are warning signs of heart attack and is should be considered a medical emergency. Clinical Governance Clinical governance is a term used by the National Health Service to describe a systematic approach in maintaining high standards of care and aims to continually improve the quality of services delivered in the clinical practice environment. Clinical governance is defined as a framework which helps all clinicians – including nurses – to continuously improve quality and safeguard standards of care (Royal College of Nursing). The role of clinical governance in this situation is to correct any mistakes that the drug and alcohol detoxification unit failed to detect. The purpose of clinical governance is to maintain and improve standards of patient care. In this scenario, it will improve the inadequate partenership between and among health care professionals dealing with the patient. It will also improve delivery of health care in other elements of clinical governance such as education and training, clinical audit, clinical effectiveness, research and development, openness and risk management. In education and training, the staff of the unit are equipped for drug and alcohol detoxification but they also need to continually update themselves with regards to medical cases in order for them to promptly idnetify life threatening symptoms such as mentioned in
Appendix: Clinical Scenario A 44 year old white Anglo Saxon male client was admitted to drug and alcohol detoxification unit for detoxification from long term use of alcohol – approximately 1 x bottle of Vodka daily. Client is obese with weight of 165Kg; Difficulty sleeping due to be investigated for same as yet has not had any sleep studies?…
Mr. Miller, a computer programmer, is a moderately obese 51 year old man with type 2 diabetes, first diagnosed 8 years ago with the disease. In an effort to improve his health, he is trying to quit his smoking habit of some 30 years.
It had been noted that data collected were important in providing an understanding to health problems previously problematic in medical language but differences of non-standard terms used by different nurses led to another barrier. The North American Nursing Diagnosis Association or NANDA standardized, identified and classified health problems dealt by nurses.
Having to go to court to file for four different torts, some definitions will be made here in an effort to clearly speak to the injustices she suffered at the hands of incompetent people. II. Definitions (100 words) Here a few definitions that are pertinent to Ms.
All this helps in defining a path and make suitable decisions as per the situation. In the modern era job switching has become a norm and the employees opt for switching the jobs extremely quickly and easily. In such a situation, the managers require that they assess the work force and they employ those people who prove useful for the organization.
However, there are those who view individualism as a mere answer to change. Those who believe in individualism agree that it teaches man to be a responsible member of his community. But then, those who do not agree to it believe that it promotes a sense of selfishness and lack of civic consciousness.
In the present case the new nurse was facing clinical and ethical problem of time management and tackling the issues of error in drug administration by previous nurse . Besides, there was emotional turmoil of the family of patient. She went for 'special' John duty to rectify the harm and must be having confusion and guilt of leaving her other patients.
Law is meant to bring order and sanity in the society. The following two scenarios provides the application of the theories of crime.
In the first scenario, a prostitute Tanya is complaining to her fellow co-worker about the cops who usually arrest
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