Okay, read your post and here is my reply:
1) Would explain to the MD that I a little busy and will be with in few minutes.
Why) This is not need ing to be dealt with at that exact moment.
2) Send the new RN into Mr. Johnson's room to assess the bleeding; for any
S/S SOB etc, mental status, whether or not there were IV's or meds that
were running and to stop them;, apply a dressing and put a call out to the
pt's MD; and report back to me.
W) This needs to be dealt with quickly by an RN
3)Have the LPN draw up the insulin doses, check for a sliding scale on the pt
with 400 glucose, and administer the insulin.
W)Insulin needs to be given so that pt's can eat.
4)Have Unit Secretary put call into into maintenance about the bathroom.
W)Nothing we can do about it until maint comes to fix it.
5) Have the LPN, RN, and assistant pass try trays, apologize for the inconve-
nience, offer to warm up anything that cooled while waiting.
W)Now we can feed everyone.
5)Now deal with medical director, apologize for the error, take responsibility
to look into the chart for the oder to find out who was on and missed it,
and assure her that chemo will started today if she stills wants it given.
W)Now you have time to deal with this problem and the MD to address the
6)Place a call to Ms. Jones family and notify them of the changes in her
w)Ms Jones condition is changed but not acute unless she did not have a
DNR in place then if not you would have made that call first.Assure the
family the vital are whatever and she is not in distress, but that they might
want to get in to the hospital.
All of the issues can be dealt with within a span of anywhere from a couple
to maybe 10-15 minutes by an experienced charge nurse. I am an RN with 20 yrs of experience and a lot of that in charge positions where I have learned
through to most important/critical things and then everything else in time.
Maybe someone else might do it differnetly but this is how I would done it.