You are caring for an eight-year-old who is in the emergency room ...

[erika]

You are caring for an eight-year-old who is in the emergency room with need for a closed-reduction of an arm fracture. The on-call orthopedic physician will be performing the procedure using conscious sedation.
 
  You are about to move the child to a different room to start an IV when the child's father asks you if you think that they should be seeking a second opinion. Because you know that families often feel the need to protect loved ones during hospitalization, what would your first response be to the parent? 1. Help the parent seek a second opinion by providing the name of another orthopedic surgeon.
  2. Tell the parent that a second opinion might be confusing for them and that the room is ready for them to begin the procedure.
  3. Review the procedure with the parent and assure them of the skill of the physician doing the procedure.
  4. Ask the parent what has prompted them to ask this question of you and how you can be of most help to them at this time.

Question 2

Which of the following is a key element for a successful system implementation?
 
  1. Effective training
  2. Incorporating data dictionaries at every terminal
  3. Providing a help desk during the day shift
  4. Finding a ancillary staff member to assist in trouble shooting the new system

[Ksh22]

Answer to Question 1

4

Feedback
1 The parent is not asking for the name of another surgeon at this time; this action does not address the question being asked.
2 This action does not answer the question being asked and it presumes the outcome of seeking a second opinion, in addition to responding to the hospital system's needs rather than family needs.
3 Family members often seek control when they are in an unfamiliar environment. Educating a family member without knowing what is of concern to them does not help develop a trusting/collaborative partnership between health-care providers and family members.
4 Seeking clarification about the concerns behind the question establishes a trusting relationship between the nurse and parent and enables the parent to assert their need for control in the situation.

Answer to Question 2

1
Rationale: Unless staff members are adequately trained and understand the usefulness and nuances of a system upgrade, the technology is not fully utilized.