Full-Spectrum Nursing Model With Nicole Peterson
A nurse should consider several factors when deciding whether to stay or leave the unit. First and foremost, a nurse should consider whether the delegated task is within his or her level of education, experience, and physical or emotional capabilities because once accepted, he or she is responsible for any malpractice or misconduct committed during the shift. The nurse should also inquire about staff availability so that he or she can report to the nurse supervisor if she requires assistance from them. Finally, the nurse should review his or her agency’s policies and procedures regarding short-staff issues.
The nurse is legally responsible once he or she accepts the task assigned to him or her. When leaving the patient care unit, the nurse must ensure that he or she reports to his or her nursing supervisor because supervisors ensure adequate staffing and patient coverage. If a nurse fails to perform this specific task, she may be fired. It is critical for a nurse to ensure that he or she has a replacement to provide care for the patient before leaving.
Standards, guidelines, and laws apply to determine whether the nurse’s behaviour was in accordance with professional standards. Nurses are familiar with and adhere to the “Nurse Practice Act (NPA),” which includes provisions authorizing a state board of nursing. This act’s guidelines include the boundaries of nursing practice and a definition of nursing, the authority, powers, and composition of the nursing board, and grounds for disciplinary action against a nurse’s license.
Statements from the “American Nurses’ Association” Bill of Rights for Nurses were considered before accepting the assignment. The statement is used as a basis for deciding whether or not to accept the delegated task, which is a nurse’s right to practice in healthcare settings in accordance with professional standards and authorized scopes of practice. Only accept a task if it is within the nurse’s experience, education, and capabilities. Furthermore, the care provided to a patient must be of high quality and exceptional in accordance with the laws governing nursing practice. Another requirement for nurses is to work in a risk-free and secure environment for both themselves and their clients. Nurses are more likely to commit malpractice in a patient care unit that is understaffed or unmanageable.
There are several factors that could lead to legal issues for the nurse. When a nurse accepts a delegated assignment, he or she assumes responsibility for any malpractice. If the assigned task becomes unmanageable due to a lack of staff, the nurse will face legal issues such as negligence and damages. The nurse may also be charged with patient abandonment if he or she was unable to report to a nurse supervisor or nurse in charge during the time when he or she left a client without the supervision of other health providers to care for another client.
Some alternative actions a nurse could take to avoid the risk of abandonment. Nurses should conduct an admission assessment to determine to who they can delegate a task, whether a nursing assistant or a licensed practical nurse. Nurses must be cautious and thorough when documenting nursing process steps because it is the best defence against a complaint or lawsuit. Nurses must be knowledgeable about and obedient to agency guidelines and procedures, such as reporting to a nurse supervisor when leaving a patient to care for another patient. Nurses must maintain competence or expertise in their field of practice in order to provide higher-quality care. Nurses should establish a good rapport with their patients by being open, honest, and respectful. They won’t know if they were treated with respect and kindness. Nurses should not blame or criticize other caregivers, particularly when a shift is understaffed.
There are times in life when a person is morally obligated to help but is unable to do so due to unforeseen circumstances. For example, a nurse and a friend are dining out in a restaurant when they notice a lady coughing up blood just beside their table. Even if they truly want to help the lady, they are hesitant because she may have tuberculosis, and they do not have a mask to protect themselves. So the best thing to do is dial 911 for assistance. In the case of unmanageable and overwhelming tasks, such as handling too many patients, half of whom are acutely ill and require close observation, the nurse has the right to refuse an assignment delegated by a nursing supervisor. Refusing to accept an assignment does not imply abandonment or neglect. It is proper not to accept because it may jeopardize a nurse’s license, especially if he or she commits malpractice.
Reference
Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic Nursing: Thinking, Doing, and Caring(2nd ).
Russell, K. A. (2017). Nurse Practice Acts Guide and Govern Update 2017. Journal of Nursing Regulation, 8(3), 18-25. doi:10.1016/s2155- 8256(17)30156-4
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Question 
Instructions
Using the client information provided, respond to the critical thinking questions. Each response should be original (in your own words) and a minimum of three sentences in length.
Full-Spectrum Nursing Model With Nicole Peterson
Client Information
Meet your client, Nicole Peterson.
Nicole Peterson is a very thin 80-year-old woman who is in the hospital after fracturing her hip. Her hip was surgically repaired four days ago, but her recovery is slower than usual because of her overall fragile health and some post-surgery confusion. One of her nursing diagnoses is self-care deficits related to weakness, pain, alteration in cognitive functioning, and impaired mobility. Her nursing orders (NIC) include self-care assistance: bathing/hygiene/toileting.
Nicole Peterson: 80-year-old female, fractured hip surgically repaired, nursing diagnosis: self-care deficits, pain, alteration in cognitive functioning, impaired mobility
As the nurse helps an unlicensed assistive personnel (UAP) with Mrs. Peterson’s bath, she notices a reddened area on her sacrum. Realizing that this may be the beginning of a pressure injury, the nurse examines the area carefully and notes a small skin excoriation in the area. She repositions Mrs Peterson to prevent further pressure on her sacrum. After finishing the bath, the nurse records her findings and enters into Mrs. Peterson’s care plan a nursing diagnosis of impaired skin integrity related to mechanical forces (e.g., shearing forces, pressure, physical immobility), alteration in skin turgor, and pressure over a bony prominence as evidenced by reddened area on the skin. She writes nursing orders, including an order to observe skin over-bony prominences every 4 hours, and then delegates to the UAP the task of turning and repositioning Mrs Peterson every 2 hours. The nurse also places Mrs Peterson on a pressure-relief mattress and obtains a foam cushion for her wheelchair.
Critical Thinking Questions
What facts and principles do you already know about the causes of pressure injury?
Do you have enough information to provide interventions for Mrs. Peterson’s actual impaired skin integrity? If not, what do you still need to find out?
What do you know about positioning clients? How would you explain to the UAP how to position Mrs Peterson “to prevent further pressure on her sacrum”?
What reassessments would you make to evaluate Mrs. Peterson’s skin integrity problem? When evaluating the diagnosis of self-care deficit, what reassessments would you make? Who can or should evaluate the issues identified? How often, or when, would you reassess?
What is one problem not described in the scenario that might arise?