You Are The Charge Nurse In A Large Urban Emergency Departme

You Are The Charge Nurse In A Large Urban Emergency Department ED Y

You are the Charge Nurse in a large Urban Emergency Department (ED). Your nursing staff include: RN with 12 years of Trauma ED experience, a new RN with 6 months ED experience, and an RN from the Medical Surgical floor with 8 years of experience. The following patients are in the ED; assign each patient to one of the nurses and explain why.

Paper For Above instruction

As the charge nurse in a busy urban emergency department, it is crucial to optimize patient care through strategic nurse-patient assignments, considering each nurse’s experience, skill set, and the patient's acuity and needs. Proper allocation ensures efficient workflow, patient safety, and quality outcomes.

The three nurses in this scenario possess distinct levels of experience and background: one with extensive trauma ED expertise (12 years), a relatively new nurse (6 months ED experience), and an experienced medical-surgical nurse (8 years). The patients present with various clinical issues requiring careful consideration for assignment.

The first patient, a 76-year-old involved in a motor vehicle accident with hematuria, presents with significant trauma-related concern that could escalate if not monitored carefully. Hematuria following trauma raises suspicion for internal injury, bleeding, or organ damage, necessitating vigilant assessment and prompt interventions. Given the importance of experience in trauma management, this patient should be assigned to the nurse with the most trauma-specific experience, the RN with 12 years of trauma ED experience. This nurse's background equips them to recognize subtle signs of deterioration, coordinate urgent diagnostics, and respond appropriately in critical scenarios.

The second patient, a 38-year-old with kidney stones experiencing severe pain, likely requires pain management, hydration, and patient education about the condition. Although this case involves discomfort, it is typically less acutely unstable than trauma cases. The patient’s needs can be effectively managed by the nurse with 8 years of medical-surgical experience, as they are proficient in managing pain protocols, administering IV fluids, and providing patient teaching. Assigning this patient to the medical-surgical nurse allows the trauma nurse to focus on more critical cases.

The third patient, a 24-year-old diabetic with an acute urinary tract infection (UTI) requiring discharge teaching, involves patient education and coordination of care rather than acute stabilization. This patient’s condition is relatively stable, but they need comprehensive discharge instructions on managing UTI symptoms, medication adherence, and recognizing warning signs. The new RN with 6 months ED experience can be assigned to this patient, providing her with a manageable case to develop her discharge teaching skills, under indirect supervision. This assignment allows the new nurse to enhance her confidence and competence in patient education without caring for unstable or complex medical cases.

The fourth patient, an 80-year-old with no bowel movement for four days, presents with a concern that could indicate constipation, bowel obstruction, or more severe gastrointestinal issues, particularly in an elderly patient. While not as immediately critical as trauma, this patient’s age and potential for rapid deterioration necessitate attentive assessment. This patient can be assigned to the medical-surgical nurse with 8 years of experience, who can monitor for signs of worsening condition, provide comfort measures, and facilitate further diagnostics if needed.

In conclusion, to ensure optimal patient outcomes:

- The 76-year-old with hematuria after trauma should go to the RN with 12 years of trauma ED experience.

- The 38-year-old with kidney stones and severe pain should be managed by the RN with 8 years of medical-surgical experience.

- The 24-year-old diabetic with UTI requiring discharge teaching should be assigned to the new RN with 6 months of ED experience.

- The 80-year-old with constipation should be cared for by the RN with 8 years of medical-surgical experience.

This strategic distribution accounts for each nurse’s expertise and the clinical stability of the patients, ultimately fostering safe, effective, and efficient care in the busy ED environment.

References

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