Question

C.R. is a 42-year-old white male who fell from a 60-foot scaffold while working on the construction of a new building. He is admitted to the emergency department (ED) by ambulance and is strapped to a rigid backboard with cervical immobilization. At the site of the accident, C.R.'s co-workers immobilized his body until the ambulance arrived. His supervisor called his wife.

Question #1: Using the principles of prioritization that you have learned in this course, answer the question: what prioritization category does cervical immobilization fall under?

C.R.'s wife arrives at the emergency department (ED) at the same time the ambulance arrives. She is very agitated and crying. He sees her as he is wheeled into the ED, reassures her that he is okay, and tells her he fell at work. You take her to a waiting room, explaining that she can see her husband as soon as he is stabilized.

Question #2: Comment on your feelings about the wife being taken to the waiting room and told she will need to wait until the patient is stabilized.

Question #3: Using therapeutic communication, write what you could say to the patient at this point in the care of the patient/family.

Answer 1

1. Cervical immobilization is primarily perform to protect the spine from further secondary damage which is one prime part of our body system. Following an accident, cervical immobilization is considered to be an intervention of very high priority as it falls under the very first step in the ABCDE principles of nursing priority where ABCDE stands for Airway, Breathing, Circulation, Disability, and Exposure. In fac, if we use Maslow’s Hierarchy of Needs for Nursing Prioritization, we will find that cervical immobilization comes to the very basic and core of physiological need.

2. If we talk about the feelings of the wife, what we have to understand here is that the women has suffered a huge loss and will surely need time to grieve. As a responsible and understanding nursing professional, the nurse should be aware of the importance of mourning for the women and should be a helping hand for her to get through it.

3. Empathy, respect, genuineness, concreteness and confrontation are known to be the five key characteristics of therapeutic communication. In this case, C.R. is in neurogenic shock in addition to spinal shock and will show symptoms like reduced reflexes, sensation loss, & flaccid paralysis. It is going to be a very tough time for him and his family. As an understanding and responsible healthcare professional, I will try to understand and be sensitive to C.R's current feelings and situation by asking him question about his felling, belief, pain and needs. I will try to value and be flexible about all his needs as well as the need and support for his family. Since he is going through a very difficult and critical situation, I will not try to give him any sort of false hope and will try to be as genuine as I could.