Legal Issues Case Study For Nursing Essay -- essays research papers

Legal Issues Case Study for Nursing Case 2 Nursing Situation: Cindy Black (fictitious name), a four-year-old child with wheezing, was brought into the emergency room by her mother for treatment at XYZ (fictitious name) hospital at 9:12 p.m. on Friday, May 13. Initial triage assessment revealed that Cindy was suffering from a sore throat, wheezing bilaterally throughout all lung fields, seal-like cough, shortness of breath (SOB), bilateral ear pain. Vital signs on admission were pulse rate 160, respiratory rate 28, and a temperature of 101.6 Â °Fahrenheit (F) (rectal). Cindy Black was admitted to the emergency department for treatment. Notes written by the emergency department physician on initial examination read, "Croupy female; course breath sounds with wheezing; mild bilateral tympanic membrane hyperemia. Chest X-ray reveals bilateral infiltrates." Medication prescribed included Tylenol (acetaminophen) 325 mg orally for elevated temperature, Bronkephrine (ethylnorepinephrine hydrochloride) 0.1 millimeter subcutaneous, and monitor results. Nurse Slighta Hand, RN (fictitious name) administered the medication as ordered and the child was observed for thirty minutes. Miss Hand's charting was brief, almost illegible, and read, "Medicines given as prescribed. Cindy observed without positive results. Physician notified." The physician examined the child; notes read that the child had "minimal clearing" in response to the bronchodilator. The following medications were then prescribed: Elixir of turpenhydrate with codeine one milliliter by mouth, Gantrinsin (sulfisoxazole) 10 Case 3 milliliters, and Quibron (theophylline-glycerol guaiacolate) 10 milliliters. Nurse Slighta Hand, RN charted the medications were given as prescribed. Her note at 11:08 p.m. read, "Vomiting; unable to retain medicine. Respiration increased (54), temperature 101.4Â °F (rectal); wheezing with increased difficulty breathing." No further notes were made regarding Cindy's condition on the emergency department record by the nurse, except to state that at 12:04 am, "child released from emergency department." Thirty minutes after discharge from the emergency department, Cindy Black was brought back to the hospital. This time her vital signs were absent, her skin was warm without mottling, and the pupils of the eye were dilated but reacted slowl... ...30 minutes) Â · Pulse rate, rhythm, quality (every 15 minutes) Â · Respiratory rate, rhythm, character (every 15 minutes) Â · Patency of the airway (at least every 15 minutes, more if in distress) Â · Blood pressure (every 30 to 60 minutes) Â · Skin color and temperature (every 15 minutes) Â · Level of consciousness (every 15 minutes) Â · Emesis amount, character, and frequency Summary: Communication throughout the nursing process is crucial for the provision of safe patient care consistent with the prevailing professional standard. Spoken communication among all members of the health-care team, and especially between nurse and physician for clarifying orders, planning patient care, and reporting significant patient observations is vital to the nursing process. Equally important is written communication by the nurse in the form of prompt and accurate entries in the medical record. References Bernzweig, E. (1996). The nurse's liability for malpractice. (6th ed.). St. Louis: Mosby Creasia, J. and Parker, B. (1991). Conceptual foundations of professional nursing practice. St. Louis: Mosby Earnest, V. (1993). Clinical skills in nursing practice. (2nd ed.). Philadelphia: J. B. Lippincott

Assessment of Patient’s Perceptions Essay

Caring has been widely discussed in the health care professions, especially in nursing which is considered to be one of the caring professions (Boykin and Schoenhofer 2001). Watson (1985) describes caring as a moral ideal of nursing. According to Watson, caring preserves human dignity in cure dominated health care systems and becomes a standard by which cure is measured (Watson 1988c, p. 177). Research literature indicates that the assessment of quality of care from the patient’s perspective has been operationalised as patient satisfaction (Dufrene 2000). Nurse caring has been related to patient satisfaction in western literature (Wolf et al 2003; Wolf et al 1998; Forbes and Brown 1995; Boyle et al 1989). There are so many factors that influence patients’ perceptions of care given by the opposite sex. Some of these are: Age, ethnicity, gender, socio-economic and health status. The most consistent finding has been related to age. Older patients tend to be more satisfied with their health care. Studies that have looked at ethnicity have generally held that being a member of a minority group is associated with lower rates of satisfaction. Studies on the effect of gender show that women tend to be less satisfied and other studies show the opposite. Most studies have found that individuals of lower socio-economic status and less education tend to be less satisfied with their health care. Other studies have shown that poorer satisfaction with care is associated with experiencing worry, depression, fear or hopelessness, as is having a psychiatric diagnosis such as schizophrenia, post-traumatic stress disorder or drug abuse. Health status can greatly influence satisfaction of an individual (Hall, 1990). It is important to examine the relationships of nurse caring to patient satisfaction in Cape Coast because of severe staff shortages, heavy workload, and low salaries in Cape Coast Hospitals. Nursing literature had long recognized importance of these perceptions as major factors militating against prompt and effective service delivery in the care environment. One of the critical roles and ethics of the nurse is to treat all patients irrespective of their gender, colour, creed, political inclination and religious affiliations. High quality nurse-client communication is the backbone of the art and science of nursing. It has a significant impact on patient well-being as well as the quality and outcome of nursing care, and is related to patients’ overall satisfaction with their care. The maintenance of high nurse patient communication also depends on the nurse and patient. The quality of care in a hospital has been shown to be influenced by several factors including: inadequate nursing staff, lack of regular water supply on wards, too much nursing documentation, too long waiting time, and lack of specialized nurses. In Ghana, there is crisis in nurse-client communication evidence from four sources. These are personal observation, anecdotes from client and their families, media reports, and official health reports. Although there is ample evidence to demonstrate that most nurses are females, one cannot discount the enormous services that male nurses provide irrespective of their gender. The ever increasing number of female nurses compared to male nurses in our wards, coupled with patient dissatisfaction toward treatment received has raised a lot of questions as to whether there is a perceived idea that male nurses offer better care or otherwise. With the introduction of Health Insurance a few years ago, more patients report to the hospital and are also consciously aware of their rights and responsibilities as patients and hence will demand for better service delivery from care givers. Recently, patient dissatisfaction has been on the ascendancy in several hospitals across Ghana including University of Cape Coast Hospital. This has raised a lot of concerns about the perceptions patients have regarding the care given by male nurses.

Avoiding Ice and Snow Damage to Trees

Brittle tree species that retain dead, persistent winter leaves normally take the brunt of heavy icing after a winter storm. Knowing and managing your brittle trees and you can make it through a normal ice storm. Many of the elms, most true poplars (not yellow poplar), silver maples, birches, willows, and hackberry are tree species that simply cant handle the weight of the ice slurry coating their limbs, persistent leaves, and needles. They do well with the snows of the north but have problems in areas that have regular ice storms. Cold climate conifers like fir, spruce and hemlock can handle moderate icing. Southern yellow pines usually take a beating during major icing events that occur on the edge of their natural range. Brittle trees tend to be fast growers. Because of their desirable growth potential and the prospect of making quick shade, weak trees are sought out and planted by homeowners in late winter ice zones. Planting these trees will only exacerbate the problem of limb breakage during heavy icing. Fast-growing trees often develop weak, V-shaped crotches that easily split apart under the added weight of ice. Because these trees usually take some damage from storms throughout the year, internal rot, decay and included bark (some of which you cannot readily see) lead to weakened trunks and limbs (some callery pears). Multiple leader, upright evergreens, such as arborvitae and juniper, and multiple leader or clump trees, such as birch, are most subject to snow and ice damage. Smaller trees need to be wrapped and larger trees with wide-spreading leaders should be cabled in ice-prone areas. Here are things you can do in the yard or landscape to prevent ice damage: Plant Only Strong Trees in Your Landscape Certain trees are popular year in and year out for a reason - they show well and live well. Prefer these trees but eliminate those I have mentioned that door poorly in ice-prone regions.   Brittle Species Should Not Be Planted These species will not do well on sites where heavy ice and snow is a problem. Brittle species include elm, willow, box-elder, hackberry, true poplar and silver maple. Avoid Planting Species With Persistent Leaves Species  that hold their persistent leaves into late fall and early winter where early ice storms are common isnt a great idea. These trees are quickly damaged and removed where the ice storm is common. Wrap Small Multi-Leader Trees So you have a valuable, small specimen you want to preserve. If ice is predicted, secure the tree with strips of carpet, strong cloth or nylon stockings two-thirds of the way above the weak crotches. Always remove any wrapping during spring to avoid binding new growth and girdling limbs and trunk. Begin an Annual Pruning Program When Trees Are Young There is not much you can do with a weak crotch so use tip 4. Prune dead or weakened limbs and excessive branches from trunk and crowns. This reduces ice weight that can rapidly destroy the trees form. Hire a Professional Arborist The expense is worth it for particularly valuable susceptible or wide-spreading large trees. An arborist can strengthen a tree by installing cabling or bracing on weak limbs and split crotches. Favor Conical Formed Trees Trees like conifers, sweetgum or yellow poplar will be robust additions to your landscape. Species with less branch surface area, such as black walnut, sweetgum, ginkgo, Kentucky coffeetree, white oak, and northern red oak are preferred.