The nurse is following a clinical pathway for a patient who has undergone hip replacement surgery. The nurse notices that the physician orders do not follow the clinical pathway. What should the nurse do first?
1. Follow the pathway as written.
2. Do as the physician orders, regardless of the clinical pathway.
3. Refuse the orders.
4. Notify the nursing supervisor, and document the variance.
4
Explanation: 1. There is an obvious disconnect between the pathway and the orders that must be resolved in order to provide quality care.
2. There is an obvious disconnect between the pathway and the orders that must be resolved in order to provide quality care.
3. The nurse should not just refuse the orders without following up on the reason for the difference and determining the best course of action.
4. It is important to recognize that each patient requires individualized care, and that pathways do not replace physician orders. The nurse should notify the nursing supervisor of the variance and the variance should be documented. The first thing that should be done is to consult the physician, not to report the problem to the supervisor.
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