ER

Main Points

Complexity Theory:

• Focus: patterns and listening to everyone’s voice
• Nurse begins assessment - this is a pattern
• Collaboration between RN, NP, shelter staff and patient
• Listening to assessment findings, direction, input of each individual helps determine which path is appropriate for the patient
• EX: Jenny speaking up about her fear of having an IV inserted. RN and NP could have dismissed this comment but instead they sat down and acknowledged her fears.

Complexity Theory

Chaos Theory

Chaos Theory:

• Health care providers have to adapt to changes often
• EX: Jenny refused to have an IV placed in her arm.
• Rationale: Most patients understand the importance of having an IV in place. This was an unexpected reaction for the healthcare providers. Instead of walking away from the situation, they adapted to it.

Assessment

• Vital for health care providers to do a thorough assessment
• Providers can find pertinent data that can help plan the next steps in treatment
• Gives providers a better understanding of the overall status of the patient from a holistic point of view

• EX: RN did an immediate assessment, where he obtained Jenny’s vitals and respiratory status.

Planning

• Takes a lot of effort and must be thorough through carefully

• EX: Airway, breathing, and circulation priority technique enables health care providers decide which direction they should take

• After coming up with a clear plan, it is then crucial for primary providers to receive input from other health care specialists

Communication

Communication

• For other health care providers to fully understand the case of Jenny Anderson, clear communication is necessary from the primary care providers
• Ensuring that everyone is on the same page is crucial in making sure no medical errors take place
• Clear communication ensures that the patient is treated effectively and efficiently and understands her plan of care even after being discharged from the hospital
• Methods for Effective Communication Include:
• Speaking directly to the patient
• Using vocabulary that Jenny can comprehend
• Having clear and specific documentation

Leadership

Leadership

The NP knows that one of her RN is experiencing burnout because J is refusing the IV insertion. Which of the following is the best thing for NP to do?

• Advise her staff to go on vacation
• Ignore her observations; it will be resolved even without intervention
• Remind her to show loyalty to the institution.
• Let the staff ventilate her feelings and ask how she can be of help.

The NP tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?

• Centralized
• Decentralized
• Matrix
• Informal

The nurse's legal role in obtaining written consent from a patient for any treatment or procedure includes which of the following? Select all that apply.

• Determining that the elements of a valid informed consent are in place
• Explaining to the patient the treatment and potential complications before he signs the consent
• Communicating the patient's needs for more information to the provider who will perform the procedure
• Evaluating whether the patient's provider has adequately explained the treatment and options before the patient signs the consent