When Everything Clinically Right Goes Wrong
As nurses, we were trained to journey through the nursing process as if marking off a check list consisting of assessment, diagnosis, planning, implementation and evaluation (ADPIE). Following “ADPIE” ensured we would provide excellent clinical care to our patients. However, what if the nursing process plays out right but the outcome is wrong?
At my organization, I work as a float pool nurse trained to work on many nursing floors. One afternoon I floated to an orthopedic surgery floor where patients undergo surgeries for broken bones. My patient was a 45-year-old female who had surgery earlier that morning for a tibia/fibula break after falling down her basement stairs. A tib/fib break involves …show more content…
Did she receive any pain relief? She was slumped forward in the bed, and could not be aroused. I immediately assessed her. Her HR was 38 and RR 4. As I checked her BP, she quit breathing and turned blue. I hit the “code blue” button initiating an overhead announcement throughout the hospital to alert emergency responders that my patient needed resuscitated.
As emergency responders performed resuscitation, I pondered what went wrong. Did I miss something in my assessment? Had I administered the correct dosage? My charge nurse determined I exercised sound clinical judgment. Although a cause for the poor outcome could not be pinpointed, I acquired an experience to add to future experiences. Knowledge that is acquired from previous experiences allows nurses to respond intuitively rather than on information gathered from a textbook (Cappelletti, Engel, & Prentice, 2014).
In closing, the nursing process provides a framework for nursing practice, but there always remains a possibility a situation can drastically change for no apparent reason. My patient was successfully resuscitated, and I came away with an experience to add to future experiences that will enhance my
As nurses, we were trained to journey through the nursing process as if marking off a check list consisting of assessment, diagnosis, planning, implementation and evaluation (ADPIE). Following “ADPIE” ensured we would provide excellent clinical care to our patients. However, what if the nursing process plays out right but the outcome is wrong?
At my organization, I work as a float pool nurse trained to work on many nursing floors. One afternoon I floated to an orthopedic surgery floor where patients undergo surgeries for broken bones. My patient was a 45-year-old female who had surgery earlier that morning for a tibia/fibula break after falling down her basement stairs. A tib/fib break involves …show more content…
Did she receive any pain relief? She was slumped forward in the bed, and could not be aroused. I immediately assessed her. Her HR was 38 and RR 4. As I checked her BP, she quit breathing and turned blue. I hit the “code blue” button initiating an overhead announcement throughout the hospital to alert emergency responders that my patient needed resuscitated.
As emergency responders performed resuscitation, I pondered what went wrong. Did I miss something in my assessment? Had I administered the correct dosage? My charge nurse determined I exercised sound clinical judgment. Although a cause for the poor outcome could not be pinpointed, I acquired an experience to add to future experiences. Knowledge that is acquired from previous experiences allows nurses to respond intuitively rather than on information gathered from a textbook (Cappelletti, Engel, & Prentice, 2014).
In closing, the nursing process provides a framework for nursing practice, but there always remains a possibility a situation can drastically change for no apparent reason. My patient was successfully resuscitated, and I came away with an experience to add to future experiences that will enhance my