A home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication
The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. What is the nurse's best action?
a. Call the physician, explain rationale, and suggest a different medication.
b. Consult an experienced nurse on whether there are other similar treatments.
c. Hold the drug until the physician returns to the unit and can be questioned.
d. Question other staff as to the physician's acceptance of nursing input.
ANS: A
Determining how best to proceed on behalf of a patient's best health care outcomes may require clinical judgment. At the committed level of critical thinking, the nurse chooses an action after all possibilities have been examined. A home care nurse who is using good clinical judgment techniques should have confidence in their decision and may not have another nurse available as this is an autonomous setting. Holding the drug might jeopardize the patient's health, so this is not the best solution. The nurse working at this level of critical thinking makes choices based on careful examination of situations and alternatives; whether or not the physician is open to nursing input is not relevant.
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