Week_6_Leadership_Management_of_a_Surgical_Unit.

Case Study (Management of a Surgical Unit) MeetheClient Me theNurseManager:LindaHatch,RNLindaHatch,RN,isthechargenurseona busysurgicalunitinamajormetropolitanhospital.Ms.Hatchisworkingwithateam composedofregisterednurses(RNs),practicalnurses(PNs),andunlicensedassistive person el(UAPs). Section1 SafeandEffectiveCareEnvironment:ManagementofCare ThechargenurseforthepreviousnightshiftisgivingaverbalreportoMs.Hatchand theoncomingstaffnurses.Duringthereport,oneoftheUAPsinterruptstostatethata clientwhois1daypostabdominalsurgeryisnowvomitinglargeamountsofgre nfluid. Question1of25 HowshouldMs.Hatchrespondtothissituation? AsktheUAPtoremainwiththeclientuntilthereporthasbe ncompletedandto perform abedbath. Avomitingclientrequiresanabdominalassessment.Assessmentisthenurse’s rolenotheUAP’s.Abedbathshouldnotbedoneuntilthesituationisunder control. GowiththeUAPtotheclient'sro m toevaluatetheclient'scondition. Thisinterruptstheshiftreport,impactingtheworkofalofthenursingstaff. Stopthereportoalowthenightshiftchargenursetoassesstheclient'sne ds. Thisinterruptstheshiftreport,impactingtheworkofalofthenursingstaff. RequesthatanightshiftstaffRNgotothero m toevaluatethesituation. Anightshiftstaffnursehasthemostrecentexperiencewiththeclientandis qualifiedtoassessandrespondtothesituation.Ad itionaly,thisassignment alowsthereportocontinuewithoutdelay. Section2 AftertheUAPleavesthereportarea,thenightchargenursestates,"ThatUAPis incompetent.Shecan'tfigureoutanythingonherown." Question2of25 Asthedayshiftchargenurse,howshouldMs.Hatchrespond? "Sheisdoingherjob.Sheshouldreportproblemstoyou." WhileitistheresponsibilityoftheUAPtoreportproblemstothenurse,this statementclosescommunicationlines.Inad ition,itdoesnotmodelaneffective waytoresolvestaffproblems. "Perhapsshene dsad itionalorientationandtraining." Becausethisresponsemayencouragethenightchargenursetocontinueto discussstaffmembersduringreport,itisnothemosteffectivestrategytodeal withthesituation. "Yourconcernne dstobead res edwiththeunitmanager." Thenightchargenurseshouldnotexpresspersonalfe lingsaboutstaff membersduringreport.Toensureconfidentiality,Ms.Hatchshoulddirecthe chargenursetotheunitmanager. "Itisyouresponsibilitytodealwithstaffproblemsonyourshift." Thisstatementclosescommunicationlines.Inad ition,itdoesnotmodelan effectivewaytoresolvestaffproblems. Section3 NursingProcess:Assessment Aftereceivingreport,Ms.Hatchassessestheacuityoftheunitandmakesap ropriate clientcareassignmentsforthenursingstaff(RN’sandPN’s)andUAP’s. Question3of25 Whenmakingclientcareassignments,Ms.HatchshouldassignwhichclientoaPN ratherthananRN? AclientwithAd ison’sdiseasewhoisexperiencingtremorsanddiaphoresis. Thisclienthasaproblem thatrequiresahighlevelofexpertisetoassessand implementaplanofcare.Therefore,thisclientshouldnotbeassignedtoaPN. Anafebrileclientwhois2dayspostoperativewithanabdominalincisionand aJackson-Pratdrain. Thisclientrequiresroutinepostoperativecare,whichcanbecompletedbythe PN. Aclientwhoisscheduledtobedischargedaftereceivinginstructionabout colostomycare. TheRNisthepersonqualifiedtocompletedischargeteachingandevaluatethe client'sabilitytoperform thene dedcare. Aclientwithdiabeteswhoreportspain2daysafteranabove-the-kne amputation. Thisclientrequiresahighlevelofexpertisetoacuratelyassesstheproblem and toplannursingcare.Therefore,thisclientshouldnotbeassignedtoaPN. ................................................continued.............................................................................