Aron Ralston, an avid outdoorsman, was hiking in a narrow canyon in Southern Utah when he upset a large boulder that rolled down the canyon after him. As it fell, the boulder relodged itself between the narrow canyon walls and in the process pinned Aron’s right wrist between the boulder and the canyon wall. Aron was alone and was unable to free himself from the situation. After being trapped for five days, with no help arriving, Aron eventually made the decision to free himself by breaking the bones in his forearm with the weight of his body and amputating his hand with a dull pocketknife. After freeing himself, he hiked an additional seven miles before the search and rescue crews found him. His arm required further surgery to repair it. After the surgery, the nurses would ask Aron, “On a scale of 0-10, what is your pain level with 0 being no pain and 10 being the most pain you have ever experienced?”. Aron would reply, “0.25”. When asked about giving such an odd answer, he stated that even though he was in pain after the surgery, it was minimal compared to the pain he experienced when he cut through his ulnar nerve to free himself from being trapped by the boulder.

1. As you reflect on this story, how does it help you understand that pain is a subjective experience for your client? What types of questions will you ask your client to adequately assess their pain level?

2. Why is it important to understand that not all clients experience pain the same?

3. What objective data may be noted when a client is in pain?

4. How might pain be manifested in vital sign measurements?

5. What effects might chronic pain have on the general health of a client?

1) Review your state’s Nurse Practice Act and rules and regulations.

2) As a coworker, what are you required to do if you believe a nurse has a problem with chemical dependency? As the nurse manager, what are your obligations? Please cite the Nurse Practice Act. 

Hospitals have noises that are buzzing day and night. Emergency Rooms, ICU’s and monitored patient floors to mention a few, have high rates of noise saturation. The most common attribution to the noise is alarms. Alarms are designed to alert staff of a change or potential change in patient status (Hebda et al., 2019). Often, the alarm going off is false or has no patient threat. This is due to parameters not being set, patches not sticking, or positioning of a sensor. This can cause alarm fatigue, “The desensitization of a clinician to an alarm stimulus that results from sensory overload causing the response of an alarm to be delayed or missed” (West et al., 2014).

The result of alarm fatigue can lead to harmful patient situations. For example, if a nurse on a busy med-surg floor has several patients on beds with alarms, patients with IV pumps infusing and on telemetry monitoring, the alarm noise from all the devices could cause the nurse to tone out some of the sounds. If one of her patient’s bed alarms continues to go off repeatedly and every time she enters the patient’s room, finds the patient in bed, she determines the sensor is set to sensitive for the patient. But if the sensor is not reset, and the alarm continues to go off, the nurse may start to ignore the alarm. The last time the alarm sounds, the patient does get out of bed and falls, injuring his hip. This can turn into a legal issue as the safety measure was in place to protect the patient from harm, but due to a failure to change the bed setting, and the nurse’s desensitization of the alarm, the patient had a poor outcome. There is an ethical responsibility for the nurse to assess the injured patient, report the fall to appropriate change according to hospital policy and discuss the incident with the patient or family members. According to Kadivar et al., (2017), that despite measures put into place in the health care setting, there are still numerous threats posed to patient safety.

Evidence suggests that alarm fatigue is a patient safety and quality concern. As health care delivery becomes more digitalized, it is increasingly important to develop a safety culture to address alarm fatigue. The research suggests establishing safe alarm management and response processes. The use of multilevel sharing practices and prevention strategies is also a way to collaborate with multidisciplinary teams on strategies for reduction in alarm fatigue (Winter et al., 2021). By decreasing the number of false alarms with use of proper management, nurses can better care for patients needs without disruptions. Thus, reduce potential missed or ignored alarms resulting in poor patient outcomes.

 

References:

Kadivar, M., ManooKian, A., Asgharican., & Zarvani, A. (2017). Ethical and legal aspects of patient's safety: A clinical case report.
Journal of Medical Ethics and History of Medicine,
10, 15.

 

Winters, B., Slota, J., & Bilimoria, K. (2021). Safety Culture as a Patient Safety Practice for Alarm Fatigue.
Journal of the American Medical Association,
326(12), 1207-1208.

https://doi.org/chamberlainuniversity.idm.oclc.org/10.1001/jama.2021.8316

Links to an external site.

 

Hebda, T., Hunter, K., & Czar, P. (2018). Handbook of Informatics for Nurses & Healthcare Professionals (6th ed.). Pearson Learning Solutions.

https://ambassadored.vitalsource.com/books/9781323903148

Links to an external site.

 

West, P., Abbott, P., & Probst, P. (2014). Alarm fatigue: A concept analysis.
Online Journal of Nursing Informatics,
18(2), 1.

Reply

What ethical issue have you recently encountered when teaching health promotion strategies to a patient? What ethical decision-making process did you use?

 

1. Explain the difference between spontaneous and procured abortion. As well as their Ethical impact of each one.
2. Why can the contraceptive pill, the IUD and the “morning after” pill also be considered abortifacients?
3. Abortion methods, depending on the stage of pregnancy. Explain each one.
4. Describe the Roe Vs. Wade case and provide a summary of Norma McCorvey’s life.
5. Describe some better alternatives to abortion.
6. Read and summarize ERD paragraphs # 45, 46, 47, 48, 49, 50, 51, 66.

 

• e clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
• If references are used, please cite properly according to the current APA style.