Part I A Nurse At An Acute Care Hospital Is Caring For A Pat

Part Ia Nurse At An Acute Care Hospital Is Caring For A Patient Who Is

Part I A nurse at an acute care hospital is caring for a patient who is not doing well. The patient is a 65-year-old male who was originally admitted four months ago following a late diagnosis of lung cancer. The patient underwent a thoracotomy and surgical removal of the left lower lobe. On this admission, the patient is diagnosed with metastasis to the bone and liver and unrelieved pain in both the left side of the chest and back. Using concepts from the readings in the assigned chapters and ISMP articles, as well as the critical elements from the AACN Health Work Environment standards and “Skilled Communication” article, answer the following question.

Paper For Above instruction

This case presents a complex scenario that highlights the critical importance of effective collaboration and skilled communication in the healthcare environment, particularly in managing patients with advanced disease and severe pain. The nurse’s role in advocating for proper pain management and ensuring respectful communication is vital to optimizing patient outcomes and maintaining a therapeutic nurse-patient-physician relationship. The following discussion explores essential concepts related to collaboration, barriers to effective communication, and addressing disrespectful interactions within this context.

Important Concepts Related to Collaboration and Skilled Communication

Effective collaboration in healthcare hinges on mutual respect, shared decision-making, and clear communication among team members. One essential concept is the “need for rapport and trust,” which facilitates open dialogue and ensures that team members can voice concerns and advocate for patients without fear of retribution or misunderstanding. In this context, the nurse must foster trust with the physician to express concerns about the patient’s pain management confidently.

Another critical concept is recognizing and overcoming barriers to communication. These barriers may include hierarchical attitudes, time constraints, or differing perceptions of patient needs. For example, in this scenario, the physician's hurried demeanor and dismissive attitude toward the nurse's concerns reflect such barriers, which can impede open dialogue and lead to suboptimal patient care.

Negative outcomes resulting from poor collaboration and communication include inadequate pain control, increased patient suffering, and potential safety issues such as medication errors. The failure to address the patient’s pain adequately may also lead to emotional distress, decreased trust in healthcare providers, and poor overall quality of life.

Disrespectful Behavior and Its Impact

The physician's remark telling the nurse “not to try and practice medicine” demonstrates a dismissive and disrespectful attitude. Such behavior undermines the team-oriented approach essential for comprehensive patient care. Disrespectful comments can create a hostile work environment, discourage open communication, and result in the nurse feeling demoralized or hesitant to advocate for the patient's best interests. This breakdown in communication can lead to delays in necessary interventions, insufficient pain management, and ultimately, poorer patient outcomes. When healthcare professionals feel disrespected, their motivation to provide optimal care diminishes, which may contribute to increased errors, patient dissatisfaction, and systemic conflicts.

Furthermore, dismissing the nurse’s assessment can result in critical information being overlooked, especially regarding pain management needs. Ensuring respectful interactions is therefore crucial for maintaining a collaborative environment where concerns are taken seriously, and patient care is prioritized.

Strategies for Responding to the Physician's Comment

In responding to the physician’s dismissive remark, the nurse must balance professionalism with assertiveness, aiming to advocate effectively while maintaining respect. Important steps include remaining calm, clarifying the patient’s needs, and emphasizing the importance of patient-centered care. The nurse might respond:

"I understand you’re busy, but I want to emphasize that this patient is experiencing significant pain, rated 7 out of 10, despite current medication. Unrelieved pain can cause further physiological and psychological complications, and considering opioid tolerance or addiction risk in this case is unlikely. Proper pain management is essential for this patient’s quality of life and recovery, and I believe we need to address it promptly."

This response acknowledges the physician’s time constraints, reasserts the importance of the patient’s pain, and utilizes evidence-based reasoning to counter concerns about addiction. It also avoids confrontational language, fostering a more collaborative atmosphere. If necessary, the nurse can also document the conversation and seek additional support from other team members or supervisors to advocate for the patient’s needs effectively.

Overall, establishing respectful dialogue and emphasizing patient safety and comfort are paramount. Engaging in skilled communication not only supports better pain management but also upholds the ethical standards of nursing practice and promotes a positive healthcare work environment (AACN, 2011; ISMP, 2023).

Conclusion

In conclusion, effective collaboration and skilled communication are foundational to high-quality patient care, especially in challenging cases involving complex pain management and escalated emotional needs. Recognizing barriers, fostering trust, and addressing disrespectful behaviors constructively are essential steps toward ensuring patient safety and optimal outcomes. Nurses must advocate assertively yet professionally to overcome obstacles and promote an environment of mutual respect and shared responsibility, thereby improving both team effectiveness and patient well-being.

References

• American Association of Critical-Care Nurses (AACN). (2011). AACN standards for acute and critical care nursing. AACN.
• Institute for Safe Medication Practices (ISMP). (2023). ISMP medication safety alert newsletter. ISMP.
• Johnson, M., & Davison, C. (2019). Interprofessional communication in healthcare: Barriers and solutions. Journal of Nursing Management, 27(3), 578–585.
• Manojlovich, M. (2019). Skills for effective communication in healthcare teams. Nursing Outlook, 67(5), 353–359.
• Street, R. L., & Haidet, P. (2016). How well do healthcare team members communicate? A systematic review. Patient Education and Counseling, 72(1), 1–7.
• Ulrich, B., et al. (2017). Building trust and collaboration in healthcare teams. Journal of Nursing Administration, 47(1), 12–16.
• World Health Organization (WHO). (2010). Framework for action on interprofessional education and collaborative practice. WHO.
• Kalisch, B. J., et al. (2018). Nurse–physician communication and collaborative practice. Journal of Nursing Care Quality, 33(4), 339–345.
• Valentine, M. K., et al. (2020). Addressing disrespectful behavior among clinicians. The Journal of Healthcare Risk Management, 40(2), 28–33.
• Reeves, S., et al. (2017). Interprofessional education: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6), CD002213.