In: Nursing
Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.
Keeping that in mind, answer the following scenario:
You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:
RN with 12 years of Trauma ED experience
New RN with 6 months ED experience
RN from the Medical Surgical floor with 8 years of experience
The following patients are in the ED, which patient will you give to each of the nurses and why?
A 76-year-old client who was involved in a motor vehicle accident and has hematuria.
A 38-year-old client with kidney stones complaining of severe pain.
A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.
An 80-year-old client that has not had a bowel movement for 4 days.
RN with 12 years of Trauma ED experience is assigned to a 76-year-old client who was involved in a motor vehicle accident and has hematuria.
Reason:
The nursing staff has well experience in trauma ED so she is suitable to take care of this client. As the client is undergone the accident, all the emergency interventions should be done as soon as possible. The cause for haematuria should be diagnosed properly and immediate medical attention is needed.
New RN with 6 months ED experience is assigned to a 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.
Reason:
The nursing staff has only 6 months experience so she is assigned to the client who doesn't need of much care. She can give the discharge advice and clarify the client doubts. Instruct the staff to take help or clear any doubts from charge nurse if she needed.
RN from the Medical Surgical floor with 8 years of experience is assigned to a 38-year-old client with kidney stones complaining of severe pain.
Reason:
Already, the staff has medical and surgical experience, so the staff will take care of the patient well. The patient has to be closely monitored for intake and output, vital signs, signs, and symptoms of infection. The nurse should also be carried out the necessary investigations. The medical management should be prioritized based on the type and size of the stone. If necessary, the nurse should prepare the patient for the surgical procedure. Improper care will lead to complication.
I (charge Nurse) will take care of An 80-year-old client that has not had a bowel movement for 4 days.
Reason:
The elderly client need support physically, psychologically, pharmacologically, mechanically, functionally. As because of old age, the nurse should assist in moving and other activities. Care to be taken to prevent falls. The client needs psychological support because of stress, depression, and confusion. The medications should be administered properly. Fluid and diet intake (fiber diet) should be changed according to the needs and wishes. Encourage for exercises and frequent changing of position is needed.