SCENARIO #1 Background: You are a new nurse hired for day/night…
Question Answered step-by-step SCENARIO #1 Background: You are a new nurse hired for day/night… SCENARIO #1Background:You are a new nurse hired for day/night rotation and most of your orientation took place during daytime shifts. During day shift, doctors were present and would put in the order sets for each admission. How to enter order sets had not been addressed in your orientation. Day shift nurses on this unit specialized in discharges, but on nights, admissions are more common. You have not been trained to do them. On your first night shift with your new preceptor, you admit your patient. Your preceptor tells you to do it all and she will just listen. Since you have not done an admission on your own, you ask your preceptor about the process was and how to enter a care plan. Your preceptor looks surprised and shocked and with an audible guffaw and, in an incredulous voice, states loud enough for the entire nurses’ station to hear, “What do you mean you don’t know how to do admission? You’ve been on orientation for how long now? What have you been learning?”Pause and process…what just happened? What behaviors are uncivil in this encounter? How should the nurse respond, using cognitive rehearsal? You completed orientation two months ago. When you approach and ask a certain nurse for help, she always says she is too busy and it will have to wait, even though she is sitting at the desk talking to another nurse and not charting. Toward the end of the shift, you overhear this same nurse talk openly and negatively to the charge nurse about another new nurse, “Chris, the new nurse on nights is always asking stupid questions. Just the other day she asked me if you flush an implantable port with heparin 100 units/mL or 1000 units/mL. They must be getting pretty desperate for nurses around here!” as she begins to laugh.Pause and process…what just happened? What behaviors are uncivil in this encounter? How should the nurse respond, using cognitive rehearsal? It is now your third month after orientation and you admit an elderly woman with a bowel obstruction. The physician orders an NG tube to low intermittent suction. You have never placed an NG tube on a real person, only the mannequin in the skills lab. When you ask her for help and clarify how to properly insert, the nurse rolls her eyes and says, “Look it up in the proceduremanual. That will tell you how step by step.” When you approach another nurse who was sitting at the nurse’s station chatting, to help you insert the NG tube, she huffs and seems annoyed at your request for help, but she does come with you to assist with tube placement. When you enter the patient’s room, this nurse says to the patient, “Your nurse has never inserted an NG tube before. I’m here to make sure she does it right.”Pause and process…what just happened? What behaviors are uncivil in this encounter? How should the nurse respond using cognitive rehearsal? You need to contact the physician for a clinical concern regarding a patient in your care. This physician is well known to other nurses to become angry and even verbally abusive towards nurses when he is called during the night. As you communicate your concern using SBAR, this physician states in a harsh and angry tone of voice, “Why did you feel you had to address this in the middle of the night? This could have waited until morning!”Pause and process…what just happened? What behaviors are uncivil in this encounter? How should the nurse respond using cognitive rehearsal? Health Science Science Nursing NUR 2356 Share QuestionEmailCopy link Comments (0)
