Professional Practice Issues - Professional Behaviors - Nursing Assessment Answer

Nursing Assessment Task

At approximately 1720 hours, Patient A reported to nursing staff that she was feeling dizzy and had abdominal pain (8/10). She was observed to have a respiratory rate of 40 -.44/min, very low blood pressure of 89/53 and a heart rate of 88.

Shortly before 1810 hours, the respondent was advised of Patient A's condition by an enrolled nurse. The respondent said that she would have Patient A reviewed once the locum arrived. At around 1810 hours, the respondent was informed that Patient A had continual diarrhoea. The respondent again said that she would have Patient A reviewed when the locum arrived. After this conversation, the respondent personally reviewed Patient A. The respondent did not document her observations. However, in her evidence before this Committee, the respondent acknowledged that Patient A's vital signs had not improved at this time.

At approximately 1910 hours, the respondent arranged for a further ECG to be undertaken for Patient A.

At approximately 2020 hours, the respondent telephoned the Clinical Nurse Manager, Ms Catherine Jones, to arrange for medication to be obtained from the drug safe (for a patient other than Patient A). At approximately 2030 hours, Ms Jones attended the Hospital and signed for the medication. The respondent did not raise any issues concerning Patient A with Ms Jones at this time.

At approximately 2100 hours, the respondent and another registered nurse completed an ISBAR (Introduction Situation Background Assessment Recommendation) form. In that form, the respondent described Patient A as "deteriorating", and recommended that Patient A's condition be reviewed "ASAP''. She also stated that Patient A's family had been contacted.

The locum, Dr Vallentine, arrived at 2200 hours. By this time, Patient A was critically unwell. The emergency on-call doctor, Dr Correy, arrived at approximately 2300 hours and inserted a large bore IV cannula to treat Patient A's severe dehydration. Over the course of the night, attempts were made to transport Patient A to a rural referral hospital. The ability to transfer Patient A was significantly complicated by Patient A's critical condition. Tragically, Patient A died whilst she was being assessed by the air evacuation team the following morning. The primary cause of death was stated to be septicaemia

1. Case Summary: Summarises the case and presenting professional practice issues.  
2. Contributory factors: Identify relevant professional errors that potentially contributed to the incident happening?
3. Implications for future practice: Discussion that includes how your practice might change and develop as a result of this learning. What professional behaviours may have made a difference in this situation?

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