21 Nov Need simple 1 and/or 2 paragraph response with 1 r
Need simple 1 and/or 2 paragraph response with 1 reference to this students post Effective communication is one of the more important aspects of being an excellent nurse. On a medical-surgical unit, it is very common for a physician to come evaluate the patient once a day, for a brief period of time. It is the nurse who spends the rest of the day with the patient, monitoring them for deterioration. Not only must a nurse be able to recognize if the patient requires a new medication or treatment, they must be able to effectively communicate with the provider, what exactly is going on with the patient, in order to obtain appropriate orders. If the nurse can’t effectively report a change in status, and a new/inappropriate therapy is ordered based on the information she has relayed, the patient can be harmed. One example that comes to mind regarding a difficult neurosurgeon I once worked with. In the hospital I worked in, we had 2 main neurosurgeons; one was a smart, fairly nice man. The other was practically a genius, but if you called him afterhours, he would scream at you, yell orders at you and tell you not to call again and that he will “see the patient in the morning”. Every nurse was scared to call the latter; we will call him Dr. X. The nurses were so afraid to get yelled at, some would call the practice to see which doctor was on call at that time. Dr. X was a brilliant surgeon, but was a completely dysfunctional communicator. He would fall into the “dominator” or “know it all” category (Kearney-Nunnery, 2016). I will keep the following story vague as to be compliant with HIPPA regulations. One night, I was taking care of a middle aged patient, who was thought to be ‘drug seeking’. The report I got was that this patient had back surgery and kept demanding more and more pain meds. I went into the room, introduced myself and asked how he was feeling. He said “when I sit on the toilet, my butt went numb”. He told the previous nurse, who disregarded it. I felt like something wasn’t right. He wasn’t asking for pain medication, he was describing a new symptom that could be serious. I called Dr. X, told him what the patient was saying. Before I could finish, he yelled at me and hung up. I composed myself, called back. He said “tell him it was positional from the OR. I’ll see him in the morning”. Before I could let him hang up, I calmly explained my concerns and asked if anything could be done. He said “order an MRI” and hung up once more. I couldn’t believe I had to call him back. I knew I could put an MRI order in, but with and without contrast? What part of the spine? The last call, he was furious, but I knew my patient needed this. I got the order and the patient went to MRI. Before the patient could even come back to his room, the operating room was calling me to say they were taking him directly from MRI. He has a massive bleed within his spinal column and needed emergency surgery. The next day, I saw Dr. X at the nurse’s station. He looked at me and said “you did good, kid”. If that patient didn’t have that surgery, he would have woken up paralyzed from the waist down. Effective communication also needs to take place between the nurse, patient and entire interdisciplinary team. As a utilization review nurse, it is my job to review the patient’s chart and determine if the patient meets inpatient versus observation criteria. One of Medicare’s rules is that the patient needs to have a 3-consecutive-night hospital stay in order to qualify for short term rehab. We cannot simply admit a patient as inpatient and keep them for 3 nights and ship them off on day 3. If we did this, it would be considered fraud and the patient can end up getting a bill for the entire hospital stay and rehab stay a few months down the line. Many physicians and families don’t understand this Medicare rule, and it is my job to explain it to them. In order for the patient to get the best possible outcome, I must use appropriate assertiveness, trust and respect. I should be aware of the patient/family culture to determine the appropriate nonverbal communication (O’Daniel & Rosenstein, 2008). When they get upset, I effectively manage my emotions and because of this, they are able to understand what I am telling them. Sometimes as nurses, we are faced with dilemmas, but I know that you should always trust your instincts. Some people are not effective communicators and I’m sure when I first started nursing, my voice trembled on every phone call. But, if you always trust your gut, it’s better to be safe than sorry. It is my feeling that effective communication is learned over time, and in healthcare it can truly mean the difference between life and death. Kearney-Nunnery, R. (2016). Advancing your career: Concepts of professional nursing (6th ed.). Philadelphia, PA: FA Davis. ISBN: 978-0-8036-4203-4 O’Daniel M, Rosenstein (2008). Professional Communication and Team Collaboration. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality (US); Chapter33.https://www.ncbi.nlm.nih.gov/books/NBK2637/
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