Intra-Aortic Balloon Pump

It is always important to follow doctor’s orders. In the New Jersey case of Szczuvelek v. Harborside Healthcare Woods Edge, that is exactly what nurses failed to do. Nurses at Harborside Healthcare Woods Edge failed to follow the hospital medical order for patient Eugene Burns stating that he be suctioned every four hours. Not only that but they also failed to follow the nursing home orders that required healthcare personnel to "suction Q shift and PRN." Burns had to be suctioned because on February 1999 he had been admitted to Robert Wood Johnson Hospital in New Jersey for treatment of an aneurysm. During that surgery a tracheotomy tube had to be inserted which left him unable to speak. On April 13, 1999, after two months of being in the hospital he was transferred to the nursing facility for

The nurse unable to convince a physician of a patient’s failing health status, can result in harm to the patient. Nurses’ and physicians’ have different styles of communication and gender differences that play a primary role in this constraint (Burkhardt & Nathaniel, 2014). Another constraint would be nursing management’s lack of support for a staff member. The nursing supervisor could have assessed Mrs. Kelly with Joanna and suggested a more detailed assessment, and possibly contacting the house physician. She herself could have called the resident and insisted that he come evaluate Mrs. Kelly’s condition or contacted the house physician. Institutional constraints that may apply here is the hospital’s lack of shared decision making processes that promote and support the nurse as the patient’s advocate. Also, Management that does not support a culture of

Thao violated the standard practice and principle of her profession. According to the ANA code of ethics Ms. Thao violated provision 2, 3, and 4. As a nurse Ms. Thao’s primary commitment was Ms. Gant, which she failed to fulfill. Ms. Thao volunteered to work extra eight-hour shift after working sixteen hours (Mason, 2007). She was knowingly taking the risk about of her duty and safety of the patient. Ms. Thao failed to finish the delegation that was given to her due to overwork by which she dishonored provision 4. She violated provision 3 by not reading the warning label on the drug bag and opening the locked cabinet with out the permission of a

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).

The physicians instead of making the call to the cardiology team sent the nurse to do so (Violation).

The two provisions from the Nursing Code of Ethics that were violated are Provision 2 and 3. Provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population” (Brown, Lachman & Swanson, 2015). Provision 2 focuses on “the nurse’s obligation to assure the primacy of the patient’s interests regardless of conflicts that arise between clinicians or patient and family”(Brown, Lachman & Swanson, 2015). Provision 2 was violated because the nurses

Although it has been many years since I rotated through an intensive care, I am sure these issues still arise. As a nurse I worked in the pediatric and neonatal ICU’s and thankfully was not exposed to this type of ethical dilemma. In those instances we did everything we could for those little lives. Today, I would report this to the manager and follow the chain of command. The staff needs education and training on end of life care and issues, legal and ethical dilemmas in relation to code status, and review of the nurse practice act. Reviewing legal cases and outcomes with the staff may also increase awareness of the dangers of practices such as slow codes. Nurses are to be healing, caring, empathetic and supportive of patients and families during critical illness, death and dying.

A child has been injured and has been rushed to a hospital by the child’s mother’s boyfriend. Once the mother arrives the doctor ask to speak with the mother privately. The mother allows the boyfriend to come and hear what the doctor needs to say. While the doctor is talking the boyfriend needs to step away to answer his phone. When he comes back the mother and doctor are both gone. The boyfriend walks over to the nurse who was there while the doctor was speaking with the child’s mother and ask the nurse to fill him in on what he missed. That’s when the nurse repeats everything the doctor had told the child’s mother. The nurse actions caused a breach in HIPAA laws because the mother never gave consent for her boyfriend to receive healthcare information regarding her child. The nurse could have avoided that HIPAA violation by telling the boyfriend she is sorry, but she can’t give him that information and to ask the child’s mother

The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for

Brassard case, No. 06636, 2010 WL 2764724, at *1 (Mass. Super. Mar. 23, 2010), where the Judgment was entered for the defendant. In this case, the court held that the defendant was not negligent in his care and treatment of the deceased patient. Here, Howard (the patient); like Honey; because of his prior medical history had significant risks of developing pulmonary embolism. He eventually died of pulmonary embolism without receiving adequate treatment to address the disease regardless his condition. The court held that Dr. Brassard didn’t depart from the standard in medical malpractice, because he wasn’t properly informed of the patient prior medical condition. Dr. Brassard’s failure to ask the patient about his previous medical condition and to read the modestly-sized medical record (29-30 pages) were not sufficient to establish negligent care and treatment of the deceased patient. Oppositely, in Honey’s case, her high exposure for pulmonary embolism was known before she departed from the Hospital. The in-home care by visiting nurses and physical therapists of Medi-Ready, Inc. purpose was to monitor her vital signs and blood pressure, and to prescribe medications in prevention of pulmonary embolism. The Court is likely to find that the non-administration of adequate treatment to prevent the pulmonary embolism was a departure from medical good practice because the physicians were informed of Honey condition

In the Code of Ethics for Nurses provision 4 states “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.” This was not done, there was no regard for human life. The patients in the hospital were treated as a burden. A meeting was held where the doctors agreed that

The charge nurse met the writer in her room and stated, "I am so glad to see you but, you have a "fresh heart" tonight.  The assignment was clearly outlined during bedside report.  But this writer quickly pointed out that she had not been heart trained and could not accept the "fresh heart".  The charge nurse validated the assignment by informing this writer that staffing was really short and she felt this writer was the most qualified nurse for the job.  The charge nurse also added, she would be available for any issues, should they arise. Logically, as the charge nurse had explained the scenario, the assignment was delegated correctly according to the available staff.  But for this writer, it was  morally wrong for her to accept the "fresh heart" knowing she was not following the outlined protocol.  Also, by caring for the "fresh heart" a question was raised if it was the safest thing for this writer to accept.  The ANA Code of Ethics Provision 4.3 states nurses are responsible for assessing their own competency within practice (P475 ethics).   Since this writer had previously validated her competency and training with the devices and medication being utilized in caring for the "fresh heart", she did not violate The Code of Ethics.   Additionally, Provision 4.3 states nurses are to accept or reject assignments based on the nurses knowledge and competence, as well as their assessment of the level of risk for patient safety (Para 1 p475).    The ethical principal of nonmaleficence could have been an issue had there had been any harm committed to the patient  by this writer. This writer knew she could have rightfully rejected the assignment due to safety concerns, but did not.   Legally, this writer did nothing wrong in caring and monitoring for the "fresh heart"

This is where the question came in that is not the protocol, why are you doing the extra step so I explained my reasoning which was wrote down. The next patient, after I had made my area clean decided that he needed his blanket right at that time. The patient proceeded to removing his arm for my clean area, as far as I know he may have touch a contaminated surface therefore before cannulation I used alcohol again. My nurse educator asked me again the question, I gave her my reason and my reason was wrote down. As a CCHT I know I am not allowed to go outside protocol without strict agreeance of the charge nurses, even on such a small infarction, due to my actions ride on the charge nurses licensure. I was called into the office and due to bring forth holes in the procedure that was not contemplated when written, my administrator and nurse manager expressed their appreciation on my work and reminded me of my certification. I found this a test of my courage, I could have completed the job according to policy then I would have not had been

The fire department received a call requesting a medical aid. We responded to the medical aid, and was told the person was not speaking right and not making any sense. I was the person who assessed the patient, I asked the patient her name and when she responded it was all garbled and unintelligibly. I assessed the patient’s airway, breathing and circulation, vital signs, completed a quick neuro exam and check patient’s blood sugar. The patient had garbled speech, facial drooping and extreme right sided weakness to the point of not being able to stand. I placed the oxygen mask on the patient to provide oxygen. I asked the chief to call and get the helicopter in the air and on its way. The chief stated that the ambulance was already on its way. I stated I wanted the helicopter. While I was taking care of the patient, the ambulance crew arrived and took over the care of the patient. After about 5 minutes I heard my chief call and cancel the helicopter, I asked him why he did that and he stated that the EMT stated we didn’t need the helicopter. I explained to my chief, I know I am not a nurse yet, and I am a new at being a fireman, and I don’t ever tell any of the fireman what to do, but I am telling you we need that helicopter. My chief called the helicopter and told then to keep coming. I spoke with the EMT explaining that the woman was having a

Ethical principals are the seed of which nursing flourishes from. Many ethical principals were involved and dishonored in this case such as, justice, autonomy, beneficence, non-maleficence, confidentiality and fidelity (Burkhardt et al., 2014). I believe justice was the main principal involved as the entire ethical predicament was revolved around unjust behavior and treatment of the residents. The residents were treated poorly and given unequal rights as a causation of their illnesses. Autonomy, an essential piece of human rights was also being violated in this ethical dilemma. The residents did not have any choice or independence in their care or how they were being treated. Beneficence and non-maleficence are significant dynamics of this ethical situation, as the health care providers needed to reflect on how they can have the maximum benefit while diminishing possible damage to the residents (Burkhardt et al., 2014). Our actions as nurses should always be beneficent and non maleficent, continuously being kind, compassionate and doing what is in their best interest as well a removing and preventing harm. Confidentiality is a key component of nursing and it was blatantly being violated as the health care