1. You are a first year RN and you have been working in the surgical ward for the past four months. Your friend Hayden from University has also started on the ward about eight weeks ago. It is time for your meal break and you had negotiated with the shift coordinator to have your meal break at the same time as your friend Hayden. When you go to collect your friend (for a meal break) you notice that he is giving an Intravenous medication to a patient but from your experience of administering this medication you know that it requires further dilution prior to being administered intravenously.
2. You are a first year RN and this is your third week in the Emergency department you have been assigned to care for four patients that have been admitted to the emergency department for treatment. Three of the four patients are comfortable with stable vital signs and all are awaiting various diagnostic test results. The fourth patient is a 26 year old female Jane Travis (accompanied by her mother) presenting with persistent headaches that have been so intense she has not been able to sleep for the past two days.
The patient was seen by the medical officer and is awaiting an MRI scan. She is on full neurological observations hourly. It is time to undertake the next set of hourly neurological observations you enter the darkened cubicle and before you say anything the patient’s mother tells you that she does not want her daughter disturbed because she has finally gone to sleep. You consult the observation chart and see that the previous two sets of observations were within normal range. You decide not to wake the patient and note on the emergency chart that you were requested not to wake the patient by the mother.
It is now time for your meal break you hand over to the coordinator who says she will keep an eye on the four patients. You return from you break to find Jane’s cubicles curtain pulled you can see from the legs showing under the curtain that it is full of staff and you see the mother crying outside of the curtain. The coordinator approaches you and explains that Jane is unconscious and the medical officer wants to know why the last set of neurological observations has not been filled in?
3. You are a first year RN who has been working in high dependency unit for the past five months. Today there have been four post-operative patients admitted from theatre following thoracic surgery. Each patient has the following: indwelling urinary catheter, intravenous analgesic infusion, oxygen therapy, central venous line for fluids and antibiotics, an underwater seal drain that is vented to the air and all are currently swinging on inspiration and two wound drains.
You know it is going to be a busy late shift. There are two third year nursing students that commenced their four week placement in the high dependency unit two days ago. The shift is progressing well and all four post-operative thoracic patients are stable with their pain under control. Alex, one of the nursing students asks if there is anything she can assist you with. You ask if she has emptied wound draining and urinary drainage bags before. The student tells you that she has in the previous vascular surgical placement. You ask if the student knows where all the equipment is kept and where to chart the drainage volume? Alex says yes and goes off to carry out the task. You are sitting in the bay with the four patients entering data from the shift. Alex has just completed empting the drains on the first of the four patients when this patient begins to gasp for breath griping the bed sheets. You immediately go and assess the patient and discover that the student had emptied the underwater seal drainage bottle.
Section 1: Student is required to describe all aspects of the critical incident including what should have happened/correct procedure.
Section2: Analyse what may have caused this situation to occur – identify all the players in the situation and their role. This requires the student to have critical awareness of all of the information and bring it together (synthesise) in a way that demonstrates the depth of the understanding about the incident without being too wordy
Section 3: Describe how you are to respond to the incident. Describe the action you must take
The essay will need to have a minimum of 10 recent (5 years or less) peer reviewed articles or credible (government/lead organisation) websites. You should use the literature to support your ideas and response to the critical incident. Please ensure that you follow the school of Nursing & Midwifery referencing style.