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I was working in an Oncology unit and was assisting in setting up a Patient Controlled Analgesia (PCA) pump. The pump was a different model than I had used in the past, and I was unfamiliar with how to set it up. I was one of four nurses trying to set it up properly by the attached instruction book. I had the most nursing experience, but I did not have any experience with this pump. We had to work fast because we had a postoperative patient in severe pain. The nurse that reported on the patient from the recovery room did not communicate that the surgeon ordered the pump. The recovery nurse did not mention that the patient was in excruciating pain. Another nurse adjusted the settings per the orders as I read the instructions. We were all rushed as the patient’s wife stood outside the patient’s room to complain about how slow we were. We finally completed it, took it to the room, and hooked the patient up to it. I signed off on the settings, and it was finally giving the patient relief. This situation happened an hour before the change of shift.
When I returned the next day, the unit director called me into the office. I had signed off on the PCA medication for the pump, and the settings were wrong. The patient received too much pain medication due to the incorrect settings in the PCA. The patient became nonresponsive. Thankfully someone noticed the settings were incorrect, and there was no further harm to the patient. I was mortified this happened and realized because of the rush, I read the instructions, but I did not watch her set the pump, and I did not check the settings. I signed off on the medication without correctly assessing the pump and the settings.
If this happened today, my process would be different. I would have called the doctor and made him aware that the pain was severe. I would request a one-time dose of medication to relieve the pain, which could take care of the patient and give me time to set up the pump correctly. I would have called the other floors for a nurse familiar with the pump to assist in teaching me how to do it correctly. I would not have signed off on the settings before visualizing the dosages and the intervals.
I had been a nurse for years and knew the correct process for performing a task I had not done before. Instead of depending on those critical thinking skills, I let the feelings of being rushed and the anxiety of the patient being in severe pain override my decision to ensure everything was correct.
Cheragi MA, Manoocheri H, Mohammadnejad E, Ehsani SR. Types and causes of medication errors from nurse’s viewpoint. Iran J Nurs Midwifery Res. 2013 May;18(3):228-31. PMID: 23983760; PMCID: PMC3748543.
Gorgich EA, Barfroshan S, Ghoreishi G, Yaghoobi M. Investigating the Causes of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint. Glob J Health Sci. 2016 Aug 1;8(8):54448. doi: 10.5539/gjhs.v8n8p220. PMID: 27045413; PMCID: PMC5016359.
An experience that disrupted my critical thought process, occurred during my second month of being a nurse. I was working on a Med-Surg. unit and one of my patients who was admitted for cellulitis suddenly had a change in mental status. The first thing I noticed was the patient wasn’t acting like herself. After taking a good look at her I noticed that her right pupil was dilated and the left one wasn’t. My critical thinking sprung into action and I immediately thought this patient is having a stroke. Although all the signs were saying yes my lack of confidence hinder my actions at first. It was my first stroke code and being a young nurse, I was afraid of calling it. However, I knew something was wrong so I muscled up the confidence and called the stroke code. I used my clinical judgement after noticing all the symptoms my patient was experiencing. The patient was rushed to CT and all the proper interventions were provided.
If I was to experience the same situation again the way I would overcome any disruption in my thinking would be to take a step back and have confidence in myself and my knowledge. A fundamental way for professional nurses in healthcare institutions to administer safe, accurate, and high-quality patient care is to gain and maintain enough certainty in themselves” (Garcia-Guerrero et al., 2022). Having confidence in yourself and what you do is an essential characteristics to have in order to perform effectively as a nurse. One specific way I would alter my way of thinking when internal forces or variables confront me would be to stay present and not get in my head. Thinking critically is an essential factor for high-quality care with the main focus being patient safety. I am constantly using critical thinking in my practice and there are times that I still question if my decisions are the best ones but I know that the more experience I gain the more confident I will be. “Professional confidence (PC) can affect all aspects of healthcare providers’ clinical performance including the relationship with clients, colleagues, and other healthcare team members, all of which influence the patient care quality” (Makarem et al., 2019).
Please make a separate comment for this 2 discussion w/ support and positive ideas , 150 words for each and 2 reference for each
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For this essay you will need to write about the community that I live in 33161, Miami dade county.
Analyzing the needs of the community and how to help achieve these needs. Providing
Statistics base on the are population, jobs, etc.
a 17 year old who deals with anxiety embarking on a once In a lifetime trip taking her out of her comfort zone
To prepare for the Discussion Task:
Review the videos titled Math Talk and
Learning Math Talk. Pay particular attention both to the
student-to-student and student-to-teacher dialog.
one of the word problems that you created and solved in your Application
Think about how a Grade 2 student might explain his or her
solution to your problem, if he or she were part of a math talk classroom.
Think about the kinds of questions that might add to, extend, and
supplement learning when students are asked to design word problems of their
Think about the degree to which you have implemented the
principles of math talk (dialog, discussion, questioning, exploration, and
visualization) in your classroom already.
Task: (Label each question you answer in your essay)
Post the word problem you selected, your solution
(including a mathematical drawing), and 1 or 2 sentences of math talk that a
Grade 2 student might generate to justify the solution.
Next, explain how you have integrated the
principles of math talk to help students on addition and subtraction situations
in your classroom. Your discussion along with your mathematical drawing will
need to be an attachment in the discussion board.
Learning Resource: Please use these sources in your essay as you
write and reference them.
C., & Zaritsky, R. (2005). Children’s math worlds videos: Math talk.
C., & Zaritsky, R. (2005). Children’s math worlds videos: Learning math
1st half of the paper : The case is a 49 year old woman with high cholestorol. You will begin by completing research on communication with your patient’s population (pediatrics, adult, elderly) along with associated patient education information for your topic area (high choolestorol) Next, create a summary of your research. (2 paragraphs ONLY, 1 about cholestorol and the other should focus on communications)
2nd half of the paper: you will develop a script that will outline the conversation between you and your “patient.” When developing the script be sure to incorporate therapeutic communication techniques, such as utilizing indirect statements and open-ended questions, providing feedback, offering comfort, etc. Be sure to label who will be speaking which parts and include non-verbal communication techniques such as, silence, posture/positioning, therapeutic touch, etc.
In 1973, the United States Supreme Court declared in a 7-2 ruling abortion to be legal in what
was perhaps the most controversial case ever, Roe v. Wade. While it’s been nearly 50 years since
this ruling, abortion remains one of the most divisive issues in our country today. Roe v. Wade
remains legal**, but many states have significant abortion restrictions in place, such as
prohibiting abortion past the first or second trimesters and requiring an ultrasound before an
abortion will be performed. Answer the following questions about your position on this
controversial law. Please note that you are free to express your opinion and will not be penalized
in any way for stating your position. You are only penalized for not thoroughly answering the
question, or for submitting this assignment past the due date. You should expect to write a
minimum of one paragraph (4-5 quality sentences) for each question.
**NOTE: As of Friday June 24, 2022, the U.S. Supreme Court has declared Roe v. Wade to be
unconstitutional. This DOES NOT mean that abortion has become illegal. What it DOES mean is
that each individual state will get to determine if abortion is permitted. This new development
will likely have no impact on your answers to these questions, but I wanted to make sure you had
the most up-to-date information available.
1. Which of the following statements best describe your position on abortion? Note: You DO
NOT have to choose one of these statements. These are simply general statements where
most people’s opinions fall.
A. There should be no restrictions on abortion. A women should be able to have an
abortion at any time during her pregnancy, including in the ninth month up until the
moment of birth, regardless of her reason.
B. Abortion should be legal for any reason, but only through the first trimester.
C. Abortion should be legal for any reason, but only through the second trimester.
D. Abortion should only be permitted in instances where the mother’s life is in danger,
where the fetus will be born with serious birth defects, or in cases of rape or incest.
E. Life begins at conception; therefore, all abortion should be illegal. This includes
situations where the mother’s life is in danger or if the fetus will be born with serious
2. Should women be forced to view an ultrasound of the fetus before getting an abortion?
Explain why or why not.