Nurse Overload: Managing High-Acuity Patients and Team Dynamics
Nurses discuss handling high-acuity patients, new admissions, and team stress. Emphasis on support, respect, and effective communication in a busy unit.
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Nursing Simulation Scenario Managing Incivility
Added on 09/27/2024
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Speaker 1: So the last three patients are pretty high acuity, but here is your fourth in 344. This is Michael Juarez. He's a 64-year-old here with onset AFib, a history of type 2 diabetes and a stage 2 wound on his left sacrum. He's allergic to penicillin. He's married and lives at home with his wife, who has Alzheimer's. He's alert and oriented times, too, and he's unable to ambulate independently. OT worked with him yesterday. He responds verbally. We're actively titrating his amiodarone drip. His lungs are clear. His blood sugar was high before breakfast, and he got seven units of insulin. His last bowel movement was two days ago. He's retaining urine due to BPH. He's on a cardiac diet and is due for a stress test at 10. Did you get all that?

Speaker 2: Wow. This is a heavy load. I better get started.

Speaker 3: There's a new admit coming from the ED. It's your turn to take it. He's coming to room 346, and the nurse will be calling with report.

Speaker 2: Okay. Thank you. Good luck.

Speaker 3: Yeah, Reina, you won't believe the day I'm having. Two nurses called out. We're getting slammed by the ED. I don't know what they expect from us. Do you need something? Yeah.

Speaker 2: I think I'm going to need some help with my patients today. All right. Okay.

Speaker 3: Just sit down. Give me a minute. I don't understand these new nurses. They don't want to work hard. They think everything should be given to them, that we should just stop what we're doing and help them. This place is going to send me to an early grave. I've had to precept all these new nurses. I've had to precept all these new nurses and manage 40 beds. We never have enough experienced nurses. And now our patient satisfaction scores are way down. I'm tired. Can you check my mom? Her call light's been on and nobody's been answering.

Speaker 2: Sure. Let's go in. Describe. D stands for describe. E stands for explain. Ms. Chowdhury, can I talk to you for a moment in private? When I asked you for help earlier this morning, you seemed a bit upset and overwhelmed. I know we've been very busy on the unit and we got slammed this morning. But the response made me feel demeaned and a little embarrassed. It's important for me to feel supported and respected when I ask for help. And with your help, I know I can be a great nurse. I can support the unit and you and we can together better care for our patients.

Speaker 3: I am so sorry, Jaslyn. I did not intend to make you feel bad. It's been a crazy morning. Guys, everything here. I got a call that my mom fell at the nursing home. No. And you know I got all those monthly reports due at the end of the day. I do value you and I will remember that. Let's get going.

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