Critical Thinking

Critical Thinking, Quality Improvement and Safety

Critical Thinking, Quality Improvement and Safety

The Discussion with the Nurse

"I work in ambulatory surgery patients treated on an outpatient basis. I want to leave nursing before something happens. Most of my patients are elderly, taking many drugs, have many problems controlled (diabetes, heart problems, blood pressure), underwent surgery open heart surgery, hip arthroplasty, surgery for cataracts, etc.. When the patient arrives in the morning for a day surgery, we have very little time to get to know and make a careful assessment. Given the complexity of care of aging patients, their medications, etc.. It is absolutely impossible for me to believe with confidence that I evaluated completely all important aspects of the patient in question in order to entrust the safe surgeon. Several years ago, things were not going well. The complexity of cases increases However, every day. One day something happens and I'll be guilty because I missed a factor about the patient's condition. The system will, however, prepare field. I must now leave the nursing profession. I occupy a position where risk gets heavier for both myself and for patients. "

The heavier workloads, pressures imposed by deadlines, frequent interruptions and the inability to predict what will happen in the workplace affect the health of nurses and, consequently, that of their patients.

Nurses need support to provide safe nursing care. Because lack of funding, they have seen disappear gradually a large number of means of support they need. It has shortened the initiation of programs nurses, and continuing education programs are less numerous. It has eliminated the positions of nurse managers and clinical support positions such as those of nurse educators and clinical nurse specialists, or it has reduced number. For many nurses, these measures have resulted in the loss of relationships significant with more experienced nurses, who are both visible and accessible. Opportunities for novice nurses to receive guidance from their colleagues experienced decreases as the workload increases and the Older nurses are retiring. The following anecdote shows the value of professional experience and the need to benefit junior colleagues.

Nurse Service prepares medication for his patients. She noted that even if the label is correct, the pills of a drug are of color different from those she had given over the previous two days. Although she is very busy, this difference concerned and she decided to take the time to call the pharmacy. It stays online long enough for someone checks. He was told it right: the pharmacy, the vial containing the drug prescribed is next to the one containing the drug that was sent in error service.

In this scenario, an experienced nurse who checked with the pharmacy. A beginning nurse she thought she would have time to call? Would she have had enough confidence to ask the pharmacy? This is a near miss incident in which anyone except the nurse in question has the same knowledge. In summary, the workplace can help nurses provide care Safe Nursing or prevent them from doing so. Currently, nurses are concerned that many factors related to their Workplaces have a negative impact on patient safety.

Nurses and other health professionals recognize that teamwork and the opportunity to ...