Author Question: A new graduate licensed practical/vocational nurse has recently begun working in a new nursing home ... (Read 58 times)

Evvie72 · **on:** Jul 17, 2018

A new graduate licensed practical/vocational nurse has recently begun working in a new nursing home and has been informed by the manager that she will be responsible to care for clients requiring mechanical ventilation.

The nurse has never cared for a client requiring mechanical ventilation, but did learn how to suction a trachea and read about caring for a client requiring mechanical ventilation. What should the nurse do in this situation?
A) Care for the clients because it is an expectation of her job, and she has a license allowing her to care for the clients
B) Watch other nurses caring for clients requiring mechanical ventilation to get an idea of how to care for the clients before caring for her clients
C) Ask the respiratory therapist to show her how the mechanical ventilator works before caring for the clients assigned, and enroll into classes to learn about caring for clients requiring mechanical ventilation
D) Ask the manager for further teaching and training about caring for clients requiring mechanical ventilation and admit that she has never cared for a client needing such care

Question 2

Hospital administration is considering a fundamental reorganization of the way that nursing care is provided in the medicalsurgical units.

The administration would like to provide more people to care for the clients' every need. To do this, the administration plans to decrease registered nurses (RN) and replace them with more unlicensed assistive personnel (UAPs) and fewer licensed practical nurses (LPN). Which is the most important consideration to base a decision regarding reorganization for nursing care delivery?
A) Cost analysis supports the change, providing more profit for the hospital, a decrease in costs to clients and insurers, and a potential for increased market because of an increase in client satisfaction.
B) Previous research studies support that a decrease in licensed professional nurses at the bedside increases rates of mortality, increases hospital-acquired infections and complications, and increases the rate of medication and procedural errors.
C) A consumer poll of clients and families supports providing more persons at the bedside to care for them when they are hospitalized; clients and families expressed that they would feel safer when more people cared for their every need.
D) A risk-to-benefit analysis supports a trial of the reorganization based upon the gain of profits versus the potential loss in any potential for lawsuits or mishaps of not identifying an unstable client in time and transferring the client to a critical care unit.

Liddy · **Reply #1 on:** Jul 17, 2018

Answer to Question 1

Ans: D
Feedback:
The nurse should always place the safety of her clients as a first priority. She needs to communicate to the nurse manager that she has not cared for clients requiring mechanical ventilation. The manager can help her get the training she needs to gain competence before caring for the clients requiring mechanical ventilation. A license and education do not equate to competency, and there is not a single nurse who knows all and can do all. Trying to care for clients requiring mechanical ventilation while trying to learn how to do so is not safe practice.

Answer to Question 2

Ans: B
Feedback:
The most important consideration should be client safety, which research suggests that a decrease in licensed professional nurses at the bedside results in an unsafe client environment. UAPs receive minimal training and need close supervision by licensed nurses. Costs analysis examines profits, and human lives should always be placed above money. A consumer poll may have asked biased questions that did not explain the motives for the consumer research, and the desires of consumers should not outweigh a potential for unsafe practice. The riskbenefit analysis examines financial losses and profit benefits. In its consideration of causes for potential losses were safety-related issues, which should be a red flag for the stakeholders, considering adopting such a nursing delivery system.