What immediate action (if any) should Rosie take? What are the responsibilities of the surgeon and senior nurse/manager?
You are waiting for a RN Rosie has been working as an anaesthetic nurse for several months and she is in the anaesthetic room with Mrs A, who is to undergo a total knee replacement. Mrs A has had a premedication, which has made her drowsy, but she is clearly still very anxious and holding firmly onto Rosie's hand. Rosie notices that Mrs A's healthcare record and her consent form both state that the procedure that she is about to undergo is a right total knee replacement. The operating list in the operating suite has Mrs A listed for a left total knee replacement.
Rosie asks Mrs A to clarify which knee she is having replaced and Mrs A points to her right knee, but tells Rosie that ‘both knees are bad'. Rosie checks Mrs A's legs to see whether the surgeon has marked the operative site for today's procedure and notes that this has not occurred.
What will be an ideal response?
Answer:
Once Rosie has identified a discrepancy between the information on the consent form and in the patient's healthcare record, the information on the operating list and the information provided by the patient, she must take all reasonable steps to clarify the situation.
Rosie must bring this discrepancy related to the site of the surgery to the attention of the senior nurse on duty and the surgical team responsible for Mrs A's care as soon as possible and prior to the commencement of the procedure.
If the surgeon can verify that the operative site is the one written on the consent form and in the patient's medical record, surgery may well proceed. If the surgeon cannot confirm the operative site, the surgery has to be delayed until certainty is achieved (e.g. the surgeon in the OR may not have previously seen the patient but can consult with the primary surgeon). Otherwise, the surgery will need to be rescheduled.
The senior nurse needs to initiate an investigation in order to identify how the wrong information came to appear on the operating list.
You might also like to view...
A patient has been prescribed an oral penicillin for an infection caused by gram-negative bacilli. When conducting health education for this patient, the nurse should emphasize which of the following?
A) The need to take the medication on an empty stomach B) The fact that a mild rash frequently follows the first few doses C) The need to increase fluid intake for the duration of treatment D) The fact that the drug should be discontinued once symptoms subside
A female patient prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this patient should be avoided while taking methotrexate?
A) Pregnancy B) Aerobic exercise C) Smoking D) Alcohol
When chemotherapeutic agents interfere with cellular physiology, it results in what?
A) Cellular death or alterations B) Diffusion C) Endocytosis D) Homeostasis
A nurse is on the treadmill exercising, when the woman next to her says, "You're a nurse. Explain to me how the scale says I've lost weight, but my waist and tummy just keep getting larger." Which of the following would be the most appropriate response by
a. "I'm concerned. You need to see your health care provider to follow up on this." b. "Muscle weighs more than fat so you're creating muscle while losing fat, but it takes a while for the body to redistribute the weight." c. "Tell me what you've been eating in the last week or so." d. "You're running so you're strengthening your legs and thighs, but to lose around your tummy, you have to exercise your abdominal muscles."