Sample Answer for NRS 415 Topic 4 DQ 2 Included After Question
Read the scenario and address the discussion question:
Scenario
You are a member of an interdisciplinary team participating in patient rounds at the start of your shift. You notice the physician charting that the patient is alert and oriented x3, but the patient was clearly confused, which the physician acknowledged during rounds.
Discussion Question
How would you approach this scenario? Apply one of the ethical principles discussed in Dynamics of Nursing: Art and Science of Professional Practice to this scenario. Discuss how organizational culture can help manage errors.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN Discussion Question Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 5.2, 6.2, 6.4, 9.1, 9.2, 9.3.
A Sample Answer For the Assignment: NRS 415 Topic 4 DQ 2
Title: NRS 415 Topic 4 DQ 2
Summary of Thoughts
I absolutely enjoyed reading your posts on how to address a difference in what was assessed and what was documented on a patient. This scenario also was complicated because there is a power issue regarding the fact that the documentation error was done by the physician. There is also the question of was this an honest mistake or perhaps reporting an assessment finding that was skewed. Your conversations were so relevant as to the scenario and how to resolve. The one thing I do know is that the discrepancy needs to be corrected. As many of you have stated you would document your observations, which is the correct thing to do. However, having conflicting documentation between the doctor and the nurse, may create greater issues should the chart end up in a court someday. I feel confident in stating that most likely, the documentation made by the physician was an innocent mistake. Approaching the situation from an advocacy point of view and to ensure that both the doctor and nurse are on the same page regarding the patient is an absolute necessity. If I had to approach this situation it would be from bringing to the attention of the doctor that I noted a difference in our assessment of the patient status and I would like to discuss to make sure that we both agree on the patient’s cognitive status. At that point, an discussion could occur about the patient and what occurred during rounding, and hopefully, at the end of the conversation, the documentation error can be noted as such.
A Sample Answer 2 For the Assignment: NRS 415 Topic 4 DQ 2
Title: NRS 415 Topic 4 DQ 2
As a newer nurse this is a scenario that I would most definitely struggle with. Relationships between nurses and medical providers can be hit or miss. Therefore, depending on my the type of relationship I had with this provider in particular, dictates the way in which I would respond. Keeping patient care at the forefront I think it is most important to seek clarification as the patients record is the only true witness to the care the patient received.
Assuming that the provider is adhering to the ethical principle of veracity, I would likely pull the provider aside and ask if they meant to chart the patient was alert and oriented x3 based on the conversation that was had during rounds (Green, 2022). I would ensure that I am being respectful and that I am not overstepping any boundaries. I may also pick up the phone and contact the provider to let them know that I saw a discrepancy that I would like to get clarification on.
Organizational culture is important for the management and reporting of errors. In lieu of placing blame or administering punishment, a culture that is open and supportive can foster an atmosphere where mistakes are seen as chances for growth and learning. Healthcare organizations need to establish a culture of safety that focuses on system improvement by viewing medical errors as challenges that must be overcome (Rodziewicz, Houseman, & Hipskind, 2023).
Green, S. (2022). Advancing professional standards. In Grand Canyon University (Ed.), Dynamics in nursing: Art & science of professional practice (second edition). https://bibliu.com/app/#/view/books/1000000000583/epub/Imprint.html#page_3
Rodziewicz, T.L, Houseman, B., and Hipskind, J.E. (2023). Medical error reduction and prevention. https://www.ncbi.nlm.nih.gov/books/NBK499956/
A Sample Answer 3 For the Assignment: NRS 415 Topic 4 DQ 2
Title: NRS 415 Topic 4 DQ 2
In this scenario, observing a discrepancy between the physician’s charting and the patient’s actual condition raises ethical concerns, particularly related to the principle of non-maleficence, which emphasizes the duty to do no harm to the patient. To address this situation, here are steps you might consider taking:
- Clarification: Approach the physician privately to discuss the discrepancy and seek clarification. Avoid accusing or blaming, but express your concern and inquire about the reasons behind the discrepancy. The goal is to understand the situation better.
- Documentation: Make accurate and detailed notes about the patient’s actual condition during rounds. This documentation can serve as a record of your observations and concerns, which may be important for patient care and any subsequent discussions.
- Communication: If the physician acknowledges the error, encourage open communication within the interdisciplinary team. Discussing discrepancies and errors openly allows for collaborative problem-solving and can contribute to a culture of continuous improvement.
- Patient Advocacy: Advocate for the patient’s well-being by ensuring that accurate information about their condition is documented. If necessary, involve the nursing staff and other relevant team members to address the patient’s confusion and update the records accordingly.
As for the role of organizational culture in managing errors, a positive and open culture can significantly impact how errors are addressed within a healthcare setting:
- Reporting Systems: An organization that encourages reporting of errors without fear of punishment fosters transparency. Establishing a non-punitive reporting system allows healthcare professionals to share information about errors, contributing to learning and improvement.
- Team Communication: A culture that values effective communication and collaboration among team members promotes the identification and resolution of errors. Interdisciplinary team rounds and regular meetings can enhance communication and coordination of patient care.
- Education and Training: Ongoing education and training on patient safety and ethical principles are crucial. Healthcare professionals should be aware of the importance of accurate documentation and be equipped with the skills to address errors promptly.
- Learning from Errors: Instead of focusing solely on blame, organizations should emphasize learning from errors. Conducting root cause analyses and implementing preventive measures can help prevent similar errors in the future.
By integrating these principles and practices into the organizational culture, healthcare teams can create an environment that prioritizes patient safety, ethical conduct, and continuous improvement.
References
Dean, J., Faulkner, A., Green, S. Helbig, J., Whitney, S. (2022). Dynamics in Nursing: Art and Science of Professional Nursing. 2nd Edition. Grand Canyon University.
Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119