Question

You are a new RN in week 6 week of a 8-week orientation. The goal of these last two weeks is to increase your patient load to near a full load. Your assignment today involves caring for 4 patients. One of the patients, Mr. Smith, will be going home, one, Mrs. Jones, will be going to surgery at approximately 11:00 a.m. and two of them are post-op patients. One of the post-op patients has multiple tubes, lines and a dressing change. The other post-op patient is receiving IV antibiotics and is anticipated to go home tomorrow.

How would you prepare for your day with your preceptor?

About 10:00 Mr. Smith is ready to go home. His discharge teaching has been completed and all forms that need his signature have been completed. You ask Tracy the nursing assistant to take Mr. Smith downstairs where his wife will be waiting to take him home. She is abrupt but says she will get it done. Joseph goes to finish preparing Mrs. Jones’ record for surgery. She is going to surgery due to a fracture of her femur. About 10:30 Joseph goes to Mrs. Jones’ room to check on her again before she goes to surgery and he notices she has the same hospital gown on that she had on early in the morning and it appears she had not been bathed. As he comes out of Mrs. Jones’room he sees Mr. Smith’s wife coming up the hall and she is visibly upset. She wants to know why her husband has not been brought downstairs.

If you were the preceptor how would you as the preceptor facilitate the new RN dealing with this situation?

Answer 1

The RN can prepare the day with the help of preceptor in the following way

• The patient who has multiple tubes ,lines and dressing change has to be assessed and attended
• The patient Mrs. Jones has to be prepared and kept ready for the surgery
• The patient Mr. Smith has to be attended next
• After the discharge process is over the other post operative patient cannot visited for care

The new RN can deal with the situation in the following way

• The patient posted for surgery has to be given the priority care. This situation can be handled by informing the nursing assistant to attend the patient and help in bathing and changing into new hospital gown. As this falls under the job responsibilities of them.
• Meanwhile Mrs. Smith who is in a state of anger has to be calmed down by sincerely apologising for the delay due to the busy schedule .This can greatly reduce the anger impact and make her to understand the situation and cooperate . If she is comfortable the patient can be sent along with her with good health wishes.

Once the discharge patient moves out the immediate care has to be focused on the pre-op preparation for Mrs. Jones and ensuring to prepare the patient before or on-time and sending to operation room on call.