Based on the level of interaction between the nurse and the patient from the time the patient woke up to the time he fell on the floor I can confidently say that the nurse was fully aware of the patient’s level of alertness. She was fully aware of the extent to which the patient was aware of himself and aware of his surrounding environment. The interactions between the nurse and the patient during the time duration in which the patient had breakfast was sufficient for the nurse to make a full assessment on the level of awareness and alertness of the patient and come up with a viable conclusion on the general state of the patient in relation to alertness to himself and alertness to the surrounding environment. The instance where the patient wanted to use the bathroom and defied the suggestions of the nurse to use the bed pan just shows how aware of the current situation the patient was and the decision by the nurse to allow the patient to use the bathroom and not the bedpan shows that the nurse was fully aware and had confidence in the level of alertness of the patient as well as the patient’s alertness in relation to their environment. It’s a known fact that a well-trained nurse and a competent one at that should be able to deduce the overall condition of the patient just from interacting with the patient and this should give the nurse the relevant guidelines to act accordingly in relation to care of the patient.
The patient weighed an astounding 250 pounds and had a relatively higher risk for a fall than other patients. Based on his excess weight it can be argued that this patient needed more specialized care and analysis than other patients. The fact however remains that this patient has been doing just fine with the help of one nurse for a very long time. The nurse helped the patient from the time he woke up all through his breakfast without any difficulty or complication whatsoever. The fact that the patient had a bedpan shows that the hospital management was fully aware of his high risk for a fall and was inclined to discouraging his use of the bathroom for a safer and less risky bedpan. The patient’s rights dictate that the patient has to be included in the decision making concerning their health. This was done and the patient took advantage of the consultations to dictate his own terms.
The nurse would decide the standard of care for this patient by carefully accessing the patient’s general awareness and also accessing how the environment would affect this patient in relation to his health condition and to his weight. The level of awareness of the patient would be determined by the nurse through careful analysis to the patient’s responsiveness to various stimuli in the environment for example the patient’s responsiveness to conversations with the nurse. The nurse could also access the standard of care necessary for such a patient based on the medication being taken by the patient and the side effects the medication has on the patient both physically and mentally. The weight of the patient and the patient’s level of stability would also help the nurse decide the standard of care for this patient in terms of mobility and moving from one place to another. The weight would help the nurse decide whether the patient would require walking aids or even a wheelchair or whether it would be necessary for the patient to remain immobile due to the high risks involved in mobility.
I would decide the outcome to this case based on the series leading up to the patient sustaining injury and the events that followed after the sustenance of injury. Despite suggestions by the nurse the patient insisted on using the bathroom. The nurse showed the patient how to get to the bathroom safely and even put in place mechanisms to call for assistance in case of any difficulty or complications. I find absolutely no instance of negligence on the part of the patient or the hospital. The patient’s current predicament was the cause of his choosing to go contrary to professional advice. This case can be summed up to negligence of professional advice by the patient. The law dictates that the patient has the right to neglect medical advice only when the patient has clear verification that this advice may be detrimental to their health which clearly was not the case hare.
References
DeLaune, S. C., & Ladner, P. K. (2004).Fundamentals of nursing: standards & practice (2nd ed.). Albany, NY: Delmar Thomson Learning.
McSherry, W. (2012).Care in nursing: principles, values and skills. Oxford: Oxford University Press.
Ring, L. (2012).A Handbook of Ophthalmic Nursing Standards and Procedures. Keswick: M & K Update Ltd..
Wan, T. T. (2010). Improving the quality of care in nursing homes: an evidence-based approach. Baltimore: Johns Hopkins University Press.
