Social Network Map Of A Night Behavioral Health Registered Nurse

Is this clearly a case when the call should be passed on to one of the registered nurses or the medical social worker?

At regular resident meeting we discuss a range of topics and the residents say what they want in the way of activates, dinner and other things. During this discussion we may talk about health issues and possible ways of dealing with them. Also I have general talks with management and colleagues and we discuss our feeling regarding raising awareness or if we may need extra training in certain areas.

I am writing this for the purpose of alerting you to a serious problem affecting many members of the medical staff. When the UCR Hospitalists took over the ER call panel, we were all promised that only unassigned patients would be admitted to their service. Furthermore, every effort would be made to insure that patients who had preexisting relationships with on staff physicians would be admitted to those physicians or their appointees. However, the UCR hospitalists have been admitting "assigned patients" to their personal service, in direct conflict with these policies.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

I shared this information with the night staff, left contact numbers and names and the Nurse was called the following morning.

Letting management know about any problems right away helps a lot because the issues can get addressed immediately. “Like any job, there may be that one person you do not get along with, but as long as you do your best to just do your job and avoid drama, you will be okay,” he says. Taking care of the patients is always the number one priority in hospitals.

Janice is responsible for the staffing of her unit (Palliative/Hospice) which has been named “The Light House” with 70 staff members working various shifts. As a manager of any unit within the Veterans Affairs Medical center, managers are expected to attend or review meetings minutes; meetings like the Nursing Council and Nurse Manager’s meetings as well as others committees. Managers are to hold staff meetings and communicate the minutes to all staff via email, or written form. Managers make sure all changes in policies, documentation, and other situations are reported to staff members. Managers are accountable for compliance of all regulatory standards, such as OSHA, CARF, and JC standards. Managers are to have an approved staffing plan, review expenditures affecting its cost, such as overtime, leave, and compensation time. Complete quarterly report/data, staffing effectiveness analysis reports, staffing updates, and FMLA information. As a manager, communication, performance improvement, staffing/recruitment, time and leave, safety/environment of care, controlled substances, adverse events/patient complaints, employee accidents/injuries, employee performance, performance appraisals and proficiencies, and staff development are all part of her duties.

    The modern day emergency room is a department that is constantly busy. In the hustle of caring for patients, there are some details of the patient’s care that can be overlooked in a standard phone report to the accepting nurse. With this in mind, a change is needed so that there is an optimum patient outcome for each and every one of the people that walk through the doors of the emergency room and get admitted.

I’m currently in an outpatient clinic at Children’s National Medical Center (CNMC), so more than in inpatient; the patient care is a bit more fragmented. There is front desk staff that checks the patient in upon arrival; a nurse then calls each back to be seen. I’m in a cardiac unit, so after each patient is properly checked in, they are asked to wait for further testing before the practitioners can examine the patient. Some of these tests include, echocardiogram and stress tests and specific lab work. But I do feel once the physicians and nurses see their patient, their needs are the main focus. We practice therapeutic communication and use open-ended questions. I’ve also notice reflective listening to be used as well.

Communication of information between health care providers is a fundamental component of patient care. The information shared during the shift exchange helps to plan patient care, identifies safety concerns and facilitates

In this article, the authors investigated the vulnerabilities in emergency department to internal medicine patient transfers through self-administered surveys of all emergency medicine house staff. More specifically, the survey investigated adverse events due to faulty communications during handoffs. According to this survey, 29% of the emergency staff reported either an adverse or near-miss event due to errors during handoffs. Furthermore, the survey respondents identified inaccurate or incomplete information, cultural and professional conflict, crowding, and many other factors as the contributors to handoff errors. By identifying specific contributors to handoff errors, this article serves as guidance for handoff intervention.

I had my first two night shift this week on Sunday 9/13 and Wednesday 9/16. I am on 7 West at Sharp Memorial Hospital and the unit is PCU unit with tele monitoring. The unit had a high census this week, but proper staffing and no codes lead to the nights being relatively calm. I was working with Laura who is not my regular preceptor. She stepped in to work with me for this week while Elle, my regular preceptor, was on vacation. I had a wide variety of patients on my two shifts. The first shift I had a patient that was suffering from an exacerbation of COPD with a history of CHF and a patient that had polycystic kidney disease, which had progressed to end stage renal failure. The second shift I had four patients; one patient had been admitted to the hospital multiple times in the past month for GI bleeds, another patient with a history of diabetes and hypertension was admitted for fever and chills and was later diagnosed with sepsis, the next patient had a history of schizophrenia and was found on the ground in her home and was expected to have been there for over 24 hours resulting in deep tissue injury, and my final patient was suspected to have a history of alcoholism and presented to the hospital with shortness of breath and an oxygen saturation of 89%. The first clinical shift I was shadowing my nurse for a majority of the shift. I was being orientated to the unit and learning where to find supplies on the unit. The second shift I took a

“Hospitals are not only required to care for emergency patients, but they also are required to do so in a timely fashion” (Pozgar, 2010, p. 272). “Hospitals are expected to notify specialty on-call physicians when their particular skills are required in the emergency department. An on-call physician who fails to respond to a request to attend a patient can be liable for injuries suffered by the patient because of his or her failure to respond” (Pozgar, 2010, p. 271). Under the doctrine of Respondeat Superior, hospitals are also liable for the actions of physicians working or on-call in their emergency department.

1.1 When going into a call the first thing that should be done is to get all the materials that you need together in order to provide care. For example, if someone is bed ridden and you are changing their pad then you will need to get the clean pad, carrier bag, toilet roll, baby wipes, towel, cream if applicable and usually the slide sheet ready. By not having everything ready you will have to stop what you are doing and go and get things. The individual during this time is rolled on their side and no doubt in some discomfort and delaying the proceedings to go and get things only increases this discomfort. After providing care all materials

As nurse manager Barbara is responsible for managing the staff, scheduling and budgeting for the unit. Her staff includes twenty-five registered nurses and eight patient care assistants (PCA’s). The unit is known for its culture of confrontation, blaming, and favoritism. The staff is dissatisfied, unmotivated, and not functioning as a team to deliver quality patient care. In Barbara’s first month she has lost two RN’s and due to a hiring freeze at EMU Barbara was not able to replace the positions. The unit is short staffed, stress levels are high and employee morale is low. Barbara meets individually with twenty or so staff members and comes to the conclusion that no one is happy and she has a lot of work to do. There are multiple groups that Barbara has identified issues with and she must come up with an action plan to manage the discrepancies. She has found issues in downward management which involves senior nurses, newer nurses, and patient care assistants, and in upward management including administrators and physicians,