01 Oct Leadership, Management and Health Care Issues in Nursing

Leadership, Management and Health Care Issues in Nursing Week 2 Assignment

Week 2 Assignment

Case Study 1

You are the nurse manager of a busy operating room in a large metropolitan hospital, serving both adult and pediatric clients. A case is scheduled involving a child who will have a hip arthroplasty. The surgical technician usually scheduled for the pediatric cases is unavailable to assist with this case, so you schedule a surgical technician who has assisted with multiple hip arthroplasties but has never performed one on a younger child. After the procedure, the child has permanent damage to his sciatic nerve, and his parents have filed a lawsuit against the surgical technician, you as the nurse manager, and the hospital.

1.            How do you suspect that the court will react to such acase?

2.            What would their findings likely be in such an instance andwhy?

3.            What could you have done to prevent thisoutcome?

Case Study 2

Judy Jones, RN, has worked in the emergency department for several years. She is currently advanced cardiac life support (ACLS) certified, as are the other emergency care nurses. Hospital policy requires ACLS certification for employment in critical care areas. One of the areas covered in attaining this certification is that the individual is taught to intubate a patient. A new hospital policy expressly forbids the intubation of patients by nurses; only physicians may intubate patients. A crisis occurred in the emergency center one evening, and Judy Jones competently intubated a patient in full cardiac arrest. The patient was successfully resuscitated and has now been discharged.

1.            Asthenursemanagerfortheemergencydepartment,whatwouldyoudoaboutthisspecific incident?

2.            How do you begin to prevent a reoccurrence of such anincident?

 3.           Could you seek assistance from others outside the hospital setting in resolving thisissue?

4.            Does the fact that the patient was successfully resuscitated alter your possibleactions?

Case Study 3

Millicent, RN, MSN is a white, 40-ish certified therapist in “healing touch.” She has been offering this therapy to her hospitalized culturally diverse post-surgical patients with good responses from them. She is aware that some research suggests that the therapy lessens the need for pain medication, reduces anxiety, and induces better sleep. Dr. Jones becomes angry when he learns about her doing “touch therapy” on his patients, which he calls “the work of the devil.” He strongly tells Millicent that she cannot do anything to his or his partner’s patients without a physician’s order.

1.            What facts should be known about the RN’s scope ofpractice?

2.            What are the ethical issues in this case between the RN and thephysician?

3.            WhatshouldbeconsideredbytheRNinrelationshipto“researchethics”?Patient’sfully informed consent? Cultural beliefs about an alternativetherapy?

Case Study 4

Ryan graduated from his BSN program about 18 months ago and has been working on a surgical unit in a large Magnet™ hospital. He belongs to his state nurses association and the Academy of Medical-Surgical Nurses (AMSN). He recently moved to another town for graduate school and took a job in a small community hospital. The new chief nursing officer is trying to create a shared governance structure. The nursing staff seems disinterested in participating in such a governance structure. Some of them complain that they do not want to “think” about nursing beyond what they have to do at the bedside. Ryan served on the practice council at the hospital where he worked after graduation. The nurses he works with now are discouraging him from volunteering to serve on one of the new councils being formed to implement shared governance. He is frustrated by his colleagues’ lack of interest in participating in decision making about nursing care. He wonders if this is the right place for him to work while in his graduate program. Although this hospital is closely affiliated with the school of nursing where he is a graduate student, the nurses on his unit openly challenge the wisdom of his decision to pursue a graduate degree.

1.Whatresourcesshould Ryan usetogainsupportforhisdesiretoparticipateinthenew shared governancestructure?

2.IfRyanwantstotestthejobmarkettofindapositioninamorepositivenursingwork environment, what resources can heuse?

3.Ryanhasbeensubjectedtoalotofquestionsandnegativecommentsbysomeofthesenior staff nurses about his graduate studies. They tend to negate the importance of advancing one’s nursing education. How can he redirect theircomments?

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