Patient safety in nursing

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I would like to get your opinion on the following scenario. Please be respectful and professional.

Nurse A takes patient B to the restroom after surgery (patient B is a female and had GYN procedure). Nurse A is with pt in restroom when she clearly needs a change of pad, mesh panty, gown etc. Nurse leaves pt sitting on toilet while she goes next door to grab supplies. The bathroom is not stocked with any supplies. Nurse A comes back in less than a minute, the pt is still sitting on toilet, but suddenly begins to decline and blacks out. The nurse velds patient head, tries to calm her down and keep her present, while she pulls the "emergency red cord".... a minute goes by and no one comes to help. Pt is back up, and fainting again. Nurse can't leave the pt or else she will fall. The nurse needs someone to come in and help this patient out, an extra minute goes by and no one comes... A tech opens the door, the nurse says get a nurse.... the tech closes the door quickly and leaves the nurse in the same situation. The nurse takes the mesh panties and opens the faucet on sink and tries to apply a wet compress to the patients head while she keeps waiting. A charge nurse appears on minute 2 and offers to bring nausea medicine and leaves again. At this point Nurse A is getting overwhelmed, all she wants is to get out there... another minute goes by, now we are getting closer to 4 minutes or more.... Nurse A, gets claustrophobic as the patient is now sweating profusely and she is afraid the patient will black out/faint again. The call light is still going. Nurse A decides to yell "Somebody HELP'.... that brings the attention from a nurse near by who brings a wheelchair and helps the nurse to get the patient out to her bed. While nurse A struggles to put the patients legs on wheelchair, there is a male nurse on the hallway, who sees the struggle, but dodges and let the two female nurses figure it out.

The patient is back safe on her bed, BP is about 90/50, and nurse A continues to care for her.

Nurse A writes an email to the nurse manager stating that she wasn't pleased with the response of the tech etc.

The charge nurse complaints to nurse manager, and nurse manager brings nurse A to unit director to talk about the incident the following day.

Nurse A is reprimanded because she was not supposed to use her voice to ask for help.

Nurse A is glad the patient was safe. She cites some safety concerns, but management thinks nurse's A is making a big deal about it, that it 's nurse A problem and who she handles the situation. Nurse A feels like there is no real support on the unit so she gives her resignation letter as she believes that protecting her license is worth more than staying and trying to convince then that there is a serious problem in that unit.

What do you think is wrong with this scenario?

What would you do if you were nurse A?

1. there are a lot of strange parts in this story, top one for me, sounds like its really about Nurse A being too freaked out about a patient's LOC change to be able to handle the situation. Why is it so important about how Nurse A was feeling. The appropriate professional focus of nurse A rather than wanting to "get out of there" would be "ensure the patient is as safe as possible". Claustrophobia is a serious psychiatric diagnosis and sounds like it would be very limiting for a nurse expected to care for any patient in enclosed spaces. I certainly wouldnt toss around the words "feeling claustrophobic" anywhere in front of management if it were me. If I were a manager, and my staff member said that word to me, as to why they made several seemingly poor decisions during a potential patient emergency, I would be watching that nurse's practice very closely in the future.

.." At this point Nurse A is getting overwhelmed, all she wants is to get out there... another minute goes by, now we are getting closer to 4 minutes or more.... Nurse A, gets claustrophobic as "

2. Nurse A could have lowered patient to the floor. If patient is on the floor, they can't fall any further. Then go get a pillow, and some VS equipment and see what's going on. Yes the floor is dirty. Its also safe...

3. The tech did exactly as ordered to do by the nurse, as is the tech's job. The nurse should explain, why she didnt tell the tech to either get a gait belt and a wheelchair, or a pillow and a VS cart.

Specializes in Family, primary care.
Specializes in Family, primary care.
27 minutes ago, ashagreyjoy said:

1. there are a lot of strange parts in this story, top one for me, sounds like its really about Nurse A being too freaked out about a patient's LOC change to be able to handle the situation. Why is it so important about how Nurse A was feeling. The appropriate professional focus of nurse A rather than wanting to "get out of there" would be "ensure the patient is as safe as possible". Claustrophobia is a serious psychiatric diagnosis and sounds like it would be very limiting for a nurse expected to care for any patient in enclosed spaces. I certainly wouldnt toss around the words "feeling claustrophobic" anywhere in front of management if it were me. If I were a manager, and my staff member said that word to me, as to why they made several seemingly poor decisions during a potential patient emergency, I would be watching that nurse's practice very closely in the future.

.." At this point Nurse A is getting overwhelmed, all she wants is to get out there... another minute goes by, now we are getting closer to 4 minutes or more.... Nurse A, gets claustrophobic as "

2. Nurse A could have lowered patient to the floor. If patient is on the floor, they can't fall any further. Then go get a pillow, and some VS equipment and see what's going on. Yes the floor is dirty. Its also safe...

3. The tech did exactly as ordered to do by the nurse, as is the tech's job. The nurse should explain, why she didnt tell the tech to either get a gait belt and a wheelchair, or a pillow and a VS cart.

Good points!

Specializes in Family, primary care.

This case was a fictional story provided by one of my students. The assignment Is called: what’s wrong with this picture?

Thank you all for your participation and feedback.

Specializes in critical care, med/surg.

As RN perdiem said, get the patient back in bed with the first person who showed up. Stabilize the patient and then write up the entire floor. Along with filing an incident report and documenting what happened. If you pull that cord you have announced to the unit that you need help immediately. Then give your two weeks notice.

Specializes in Critical Care.

It sounds as though 'nurse A' freaked out unnecessarily, to the point where she couldn't even effectively communicate what is was she felt she needed in terms of help.

I'm not really clear on what supposedly occurred, she "blacked out" but while that was occurring 'nurse A' was "trying to calm the patient down" which doesn't sound very unconscious.

I think the nurse became overwhelmed and instead of evaluating that situation and how she could have handled differently, she is assigning blame for her feeling overwhelmed in what should have been a manageable situation on other staff.

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