A nurse manager is asking the staff how to improve conditions on ...

[londonang]

A nurse manager is asking the staff how to improve conditions on the unit. A new nurse on the unit relates that a client complained because family members were able to hear the verbal report outside the room during nursing rounds.
 
  The nurse might suggest that: 1. Nursing rounds take place in instead of outside of the client's room.
   2. The unit be closed to family and visitors during rounds.
   3. Clients be allowed to choose whether a written or oral report is used.
   4. Nurses tape record their reports outside the room.

Question 2

The nurse has given the client pain medication based on the client's reporting a pain level of 7 out of 10. Upon evaluation of the treatment after 1 hour, the client reports that the pain level remains at 7. The nurse plans to:
 
  1. Report to the physician by telephone.
   2. Include in the nursing report that the medication is ineffective.
   3. Increase the dosage of the medication.
   4. Wait for the doctor to make rounds to report the problem.

[yasmin]

Answer to Question 1

2. The unit be closed to family and visitors during rounds.

Rationale:
In order for the client's privacy to be protected, closing the unit during nursing rounds permits nurses to talk freely and relate important information regarding the client and care. Rounds could take place in the room, but if the family is present, confidentiality is compromised. The staff and manager should determine the form of report used, keeping in mind the confidentiality of the client. Taped reports are acceptable if conducted in private but not out on the unit.

Answer to Question 2

1. Report to the physician by telephone.

Rationale:
In this case reporting to the physician by telephone is appropriate. The nurse would address the client's distress immediately and later include the event in the end-of-shift report to the oncoming nurse. The nurse cannot alter the dose of medication. Waiting for the physician to arrive could cause the client to experience a great deal of pain in the interim.

[londonang]

Thanks

[yasmin]

Welcome