Failure of a Nurse to Give Water to a Dehydrated Patient - Lab Report Example

A critical incident report A critical incident report Nurses play a significant role in the health outcome of patients. They maintain constant contact with the patients, thus contributing to their safety, and improving the quality of care, they receive (Sherwood & Zomorodi, 2014). However, given that man errs due to his nature, some incidences lead to fatal consequences for the patient. One of the major problems in healthcare relates to dehydration. Research indicates that this problem prevails more amongst older people, compared to young individuals, and it accounts for a high rate of hospitalization (Lecko, 2013). Therefore, giving dehydrated patients enough water serves to increase the ability of the patient to fight other illnesses, hence promoting their safety (“National Patient Safety Agency”, 2007). Consequent to this, the following discussion highlights one of the incidences that involved failure of a nurse to give water to a dehydrated patient. The error worsened the condition of the patient, increasing harm to the patient. Description of the incident I once observed an incidence that occurred in the surgical ward involving an elderly man, who was admitted with critical limb ischaemia. His right leg was greatly affected, thus causing him a lot of pain. The patient was also frail and was diagnosed with dehydration on admission, which characterizes many elderly patients (Scales, 2011). Therefore, an overnight plan was laid out to help him rehydrate his body. The plan consisted of close monitoring of the patient’s fluid balance as he was to be given plenty of water for the night. More to this, his urine measurements were to be taken on an hourly basis. However, the nurse on duty did not follow the plan as expected. The nurse seemed a bit tired on this particular night, thus spent little time with the patients. The patient received 1000ml of water in 12 hours, as the nurse did not take heed to the doctor’s instructions to monitor the patient closely. Additionally, the patient received only four urine measurements as opposed to the hourly measurements. The patient’s output remained dangerously low during the entire period, but no action was taken to try and seek a solution for the patient. This made the condition of the patient worse as he was still dry, and made little urine in the morning. More to this, the leg of the patient had worsened, and the chances of salvaging the leg were quite low. This situation compromised the safety of the patient as water plays a critical role in a patient’s body. Therefore, denying this patient the water required by his body made his condition worse, instead of helping him deal with the problem at hand. Legal, ethical, and/or professional issues highlighted by the situation and their relation to professional responsibilities as a registered nurse Legal issues Nurses owe the patients placed under their care a legal duty of providing them with proper medical care (Jonasson, Liss, Westerlind, & Berterö, 2011). Admitting a patient means that the hospital accepts to give the patient their best. Therefore, failing to do so gives the patient the right to sue them for medical malpractice, and such suits are intended to stimulate provision of better quality of care (Konetzka, Park, Ellis, & Abbo, 2013). In this particular case, the nurse acted in a negligent manner. This means that the nurse did not give the patient the standard of care, which any other healthcare provider in the same situation would have given the patient. Given that the patient was not in control of the water, it was not possible for the patient to take the fluid without the help of the nurse (Ruxton, 2012). This adds to the duty of the nurse towards the patient. However, the nurse failed to follow the instructions given by his superior. He did not administer the patient with the required volume of water, thus making him more dehydrated, than when he was admitted. Consequent to this, the nurse endangered the health, as well as the life of the patient, who depended on the nurse for help. Such negligence qualifies as misconduct, and the nurse can be sued for not giving the due care to the patient. Ethical issues According to Ewashen, Mcinnis-Perry, and Murphy (2013), professional nurses have the responsibility of collaborating with other medical practitioners in order to provide patients with the best medical care. Consequent to such responsibility, the nurse ought to have followed the directions given by the doctor, to enhance the well being of the patient. In addition to this, nurses have the moral duty of building a moral community in the places that they take care of the patients. Such moral communities consist of areas that patients are treated with the required dignity. However, this situation lacked dignity for the patient as his needs were not met, thus deteriorating his health. Water helps in improving the condition of a patient as water improves the ability of the body to fight illness. Therefore, giving water to a dehydrated patient conforms to the principle of beneficence, which relates to doing well and averting any harm from the patient (Denny & Guido, 2012). In this incident, the nurse failed to administer the patient with water, thus neglecting the principle of beneficence, which leads to professional misconduct. Discuss how you would manage a similar situation differently in the future. Suggest and rationalize strategies that will support your improved future practice Research indicates that up to 25% of older patients also suffer from dehydration (Archibald, 2006). This means that nurses should take the hydration requirements of such people with a lot of emphasis. They should realize that committing, such errors as in this situation compromise their ability to give appropriate care, which can lead to the death of a patient. More to this, nurses care for vulnerable people, who may not have the autonomy to perform various activities for themselves. Consequently, patients put their trust and confidence in them, and hope that they would give them the best care towards their recovery (Dinç & Gastmans, 2013). Following such dependability, nurses should be educated on the need for providing patients with water without fail. Older patients should be administered with water as a basic rule, unless the condition of the patient proves otherwise. Nurses should also pay attention to the instructions given by their superiors, and ensure that they carry out the orders as required. Consequent to this, I intend to prioritize the hydration requirements of all patients under my care, and shall adhere to the specific directives of my seniors. Zolnierek states that knowing patients also serves as another strategy that nurses can use to reduce such errors (2014). Therefore, the number of nurses on duty should be enough to attend to the hospitalized patients at any particular time. Hospitals should employ more staff where the nurses are few to give nurses an opportunity to concentrate their efforts on an average number of patients. This keeps the nurses from being over exhausted, thus giving the best quality of care to the patients. Such measures require hospitals to increase their budget as more nurses mean spending more on salaries. Therefore, I look forward to forming good relations with patients under my care, to improve the quality of care I offer to them. Providing positive environments also contributes to promoting the quality of care offered by nurses. Positive environments keep the nurses motivated, thus allowing them to perform their duties diligently, unlike environments that demoralize the employees, which results in poor performance. Positive environments include organizations that acknowledge the effort of nurses, and make them proud of the work they do. More to these, doctors and other superiors ought to respect nurses, and avoid abusive environments. Healthcare organizations also ought to promote a culture of safety in their organizations. This can be created through influencing the attitudes and values of the people who work in these organizations. Such values can be passed on through education, and giving real experiences in the institution with an intention of promoting safety, just like I intend to do. Conclusion Conclusively, most of the incidences that happen in nursing can be prevented. Nurses have a role of giving their best to patients under their care, and they should strive to fulfil this requirement. They can get additional training in relation to the areas they get assigned, as well as improve the attitudes and values they have. Te institutional also plays a significant role in helping nurses, by providing a conducive environment to work. References Archibald, C. (2006). Promoting hydration in patients with dementia in healthcare settings. Nursing Standard, 20(44), 49-52. Denny, D., & Guido, G. (2012). Undertreatment of pain in older adults: An application of beneficence. Nursing Ethics, 19(6), 800. Dinç, L., & Gastmans, C. (2013). Trust in nurse–patient relationships: A literature review. Nursing Ethics, 20(5), 501-516. Eisenberg, S. (2010). Protect Yourself from Nursing Negligence or Malpractice: Negligence or malpractice accusations can be devastating to your career. Learn what precautions to take to prevent this from happening. Ons Connect, 25(4), 25-29. Ewashen, C., Mcinnis-Perry, G., & Murphy, N. (2013). Interprofessional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335. Jonasson, L., Liss, P., Westerlind, B., & Berterö, C. (2011). Empirical and normative ethics: A synthesis relating to the care of older patients. Nursing Ethics, 18(6), 814-824. Konetzka, R., Park, J., Ellis, R., & Abbo, E. (2013). Malpractice Litigation and Nursing Home Quality of Care. Health Services Research, 48(6), 1920. Lecko, C. (2013). It is dangerous to think that ending dehydration is simple. Nursing Times, 109(26), 11. National Patient Safety (NPS). (2007). Hospital Hydration Best Practice Toolkit. Royal College of Nursing. Web < http://www.rcn.org.uk/__data/assets/pdf_file/0003/70374/Hydration_Toolkit_-_Entire_and_In_Order.pdf> Ruxton, C. (2012). Promoting and maintaining healthy hydration in patients. Nursing Standard, 26(31), 50-56. Scales, K. (2011). Use of Hypodermoclysis to Manage Dehydration. Nursing Older People, 23(5), 16-22. Sherwood, G., & Zomorodi, M. (2014). A New Mindset for Quality and Safety: The QSEN Competencies Redefine Nurses Roles in Practice. Nephrology Nursing Journal, 41(1), 15-72. Zolnierek, C. (2014). An Integrative Review of Knowing the Patient. Journal of Nursing Scholarship, 46(1), 3. doi:10.1111/jnu.12049 Read More