The nurse is caring for a patient with severe arthritis and ...

[cartlidgeashley]

The nurse is caring for a patient with severe arthritis and notices a written pain medication order that appears to have an extremely high dose. She places a call to the physician to question the prescription dose.
 
  Which statement below best describes an assertive communication style by the nurse in interacting with the physician regarding the pain medication order?
  a. I'm calling about the pain medication prescription for Mrs. Garcia. The dose is too high.
  b. Sorry to bother you but I'm not sure about the dose of pain medication you prescribed for Mrs. Garcia.
  c. I'm concerned about the medication dose you prescribed for Mrs. Garcia.
  d. You may disagree with me, but the dose for Mrs. Garcia is too high.

Question 2

The nursing student is assigned to care for a patient who has just been diagnosed with advanced stage cancer. The patient is very upset and crying. The nursing student states to her instructor, I don't know what to do.
 
  My patient just can't stop crying. What is the best response from the instructor?
  a. Sometimes just sitting with patient and remaining silent can be the best care.
  b. You will need to wait patiently until your patient stops crying to complete your care.
  c. You will not be effective while he is crying. Tell the patient you will come back later.
  d. Try to distract the patient from crying by trying to change the conversation.

[jliusyl]

Answer to Question 1

C
Effective communication and teamwork are essential to the delivery of high-quality, safe patient care. To avoid communication failures that can lead to unanticipated adverse events in patients, nurses must speak up when they have concerns and take the necessary steps to communicate assertively and collaboratively with the healthcare team. To advocate for patients, nurses must question care decisions that don't seem right and assertively discuss errors or poor clinical judgment. In this item, the most appropriate and assertive communication is to state that there is a concern regarding the dose of the medication. This will lead to collaborative dialogue between the nurse and physician. This is an open and honest response. The response sorry to bother you is ineffective, as it is self-effacing, apologetic, and inappropriate in a professional role. Stating to the physician that the dose is too high may be offensive, as it is too direct, challenging, and aggressive. In fact, the dose may be acceptable. Stating, You may disagree with me but . . . is also self-effacing, as the nurse is not defending her concern for the safety of the patient.

Answer to Question 2

A
One of the most effective and useful tools in enhancing therapeutic communication is the use of silence. Using silence demonstrates acceptance and allows the patient to compose his thoughts and perhaps provide other information. It is especially effective when the patient is emotionally upset. Waiting for the patient to stop crying to complete care is a missed opportunity for the nurse to support the patient's emotional needs and show caring during a difficult time. Additionally, the patient would be denied the opportunity to express his feelings, fears, and other emotions. Distracting patients or changing the topic of the conversation is actually a barrier to communication. This may make the patient feel that his feelings are not accepted or warranted, or that the nurse is uninterested.

[cartlidgeashley]

TY

[jliusyl]

You're welcome