Cialis canada (ADDENDUM, cialis canada ADDED FEBRUARY 14, cialis canada 2012 – When this post was written, cialis canada I mistakenly thought the patient in question had a transplant operation pending. Cialis canada The patient was actually scheduled to be transferred the next day to begin pre-transplant testing. Cialis canada Surgery would have come at a later date.
Cialis canada I now understand that Amanda assessed that the patient had a deficit of transplant knowledge in general, cialis canada and provided general transplant teaching concerning the evaluation process, cialis canada the waiting process, cialis canada and the care regimen. Cialis canada The patient changed their mind about undergoing the testing, cialis canada and requested a hospice consult.
Cialis canada So, cialis canada although the patient did not fully understand, cialis canada and may not have been “informed” about what the entire transplant process required, cialis canada surgery was not imminent, cialis canada and “informed consent” for surgery was not the issue here. Cialis canada
Cialis canada I have a firm belief in not altering a post once it has been posted, cialis canada and owning the mistakes/misunderstandings therein, cialis canada so I have added this addendum for clarification.
Cialis canada The issues remain the same – a patient was uninformed about what was happening to them and needed education on their illness, cialis canada a physician/hospital did not support/respect a patient’s decision/request for information, cialis canada and a physician behaved in a disruptive fashion.
Cialis canada I apologize for the misunderstanding.)
Cialis canada Nurses and physicians share a collaborative relationship, cialis canada working with the patient in a team effort.
Cialis canada That is how it is supposed to work.
Cialis canada As a nurse, cialis canada my duty is solely to the patient.
Cialis canada If I am needed to be anyone’s “right hand”, cialis canada it will be my patient.
Cialis canada I’m very lucky. Cialis canada I work with great docs who get it. Cialis canada I’ll write a post about that.
Cialis canada I’ve seen my share of the temper-tantrum throwing screamers, cialis canada and I’ve been the recipient of their wrath three or four times in my career.
Cialis canada I should tell those stories; they happened long ago. Cialis canada I’ve kept them off the blog because of the emotions that come flooding back when I think about them.
I’ve been blogging on the Amanda Trujillo situation for a few days now, cialis canada but lets move away from Amanda being fired by Banner Health and turned in to the Arizona Board of Nursing and look at this from a patient’s point of view.
As I see it, cialis canada based on information that has been made public or is in the public record, cialis canada three things occurred or nearly occurred (In hospital terminology, cialis canada we call those “near-misses.”)
This should make everyone of us queasy.
1. Cialis canada A PATIENT WOULD HAVE HAD SURGERY WITHOUT INFORMED CONSENT.
A patient scheduled for surgery, cialis canada in this case a major, cialis canada life-altering surgery, cialis canada did not know (a) the extent of the surgery, cialis canada (b) the ramifications of the surgery – this being complex lifetime care, cialis canada or (c) options other than surgery.
All of the above, cialis canada along with the risks and benefits of the surgery, cialis canada constitute “informed consent.” Before any surgery consent can be signed, cialis canada all of the above must be addressed.
Before the discussion with the nurse, cialis canada the patient did not know this information.
2. Cialis canada A PATIENT’S DECISION WAS NOT SUPPORTED BY THE MD, cialis canada OR THE HOSPITAL
Granted, cialis canada the surgery did not happen. Cialis canada But instead of supporting the patient’s decision as being the patient’s decision after the patient had been fully informed, cialis canada as was their right by law, cialis canada there was anger and recrimination from the physician and the facility.
Why did a patient’s decision to not have surgery cause this upheaval? Who lost out here?
I’m speculating, cialis canada but I wonder – how much of that anger did the patient hear, cialis canada or sense?
3. Cialis canada A PHYSICIAN DISPLAYED DISRUPTIVE BEHAVIOR AT THE NURSES STATION.
Well, cialis canada this has been going on from time immemorial, cialis canada but it is no longer tolerated.
Now, cialis canada concern over a patient is not disruptive behavior. Cialis canada Anger is not a disruptive behavior. Cialis canada (If it was, cialis canada I’d be in trouble.) Screaming and throwing a temper-tantrum at a nursing station is, cialis canada no matter what the reason.
How would you feel as a patient if you heard a screaming rant going on at the nurse’s station outside your door?
How would you feel about the doctors, cialis canada the facility? The nurses?
Two of these, cialis canada the informed consent and the disruptive behavior are issues that are covered by licensing bodies. Cialis canada Joint Commission has looked at the impact of disruptive behavior by physicians and other members of the health care team. Cialis canada The Centers for Medicaid and Medicare Services are also concerned with the effect of this behavior of patient safety.
What happened at Banner Health Del E. Cialis canada Webb Medical Center was not innocuous.
If not for the actions of a registered nurse, cialis canada doing exactly what she was educated to do, cialis canada and bound by the Arizona Nurse Practice Act (and her ethical duty) to do, cialis canada a patient would have had a surgery they were not prepared for, cialis canada and would not have wanted had they known what was happening.
That should scare the hell out of every single one of us.
Cialis canada Because something like this has a chilling effect on all the other RNs in a facility – and I hope that the other registered nurses at Banner Health have the guts to keep educating their patients without the fear of losing their jobs and their licenses for doing their ethical duty.
Cialis canada As a nurse, cialis canada and as a patient, cialis canada I am appalled.
Cialis canada Now I want to see exactly what Banner Health, cialis canada and the Arizona Board of Nurses, cialis canada are going to do to rectify this situation.
Cialis canada This has huge implications for nurses, cialis canada and patients.
Cialis canada All of us.