DQ: Decision making and professional development

This Module addresses issues such as problem solving, prioritising and putting decisions into action through good communication.

As part of this module please undertake the following activity and upload your answer into your e- Portfolio. Please remember that this forms part of your assessment for this unit.

On returning from your tea break you are met by several staff members who relate the following information to you concerning your patients.

i. Mrs Chew’s intravenous (IV) infusion has tissued, her IV fluids are running behind and she has missed her 14.00 hrs IV antibiotic.

ii. Mr Smith’s visitor has fainted.

iii. One of the staff toilets has blocked and is overflowing and waste is pouring out rapidly.

iv. Mr Esposito is scheduled to leave the ward now for his cardiac catheterisation and he has still not received his preoperative medication.

v. One of the surgical consultants (VMO) is waiting to discuss a medication error that happened last week.

vi. As you are taking this handover, an elderly female post-operative patient collapses to the floor and is unconscious. She has had facial surgery.

The other RN is busy with NUM role. Staff currently available on the ward to assist you in addressing these issues include: the ward clerk, an Enrolled Nurse who is currently undertaking her IV cannulation certificate but is not yet competent, and an AIN.

ACTIVITY

Using the above scenario:

1: In order of priority, identify which tasks you yourself will undertake and which tasks you will delegate.

2: Document your rationales in detail.

Module 2 – Collaborative and Therapeutic Practice This module requires you to consider your communication with various members of the multidisciplinary team using case studies and scenarios provided.

Your mandatory assessment requirements for module one include

1. Complete Activity 2 and upload your answers onto your e-Portfolio.

2. Choose one case study and upload your answers onto your e-Portfolio.

ACTIVITY 2

Reading:

The “MND Australia Fact Sheet on Multidisciplinary Teams” outlines professional groups who could make up a multidisciplinary health care team for a patient with motor neurone disease (MND).

Please read this fact sheet, answer the following questions, and upload your answers on your e-Portfolio on LEO. This forms part of your assessment for this unit.

1. Identify factors that determine which healthcare professionals are required to be involved in a health care team?

2. Who should lead the health care team?

3. Who is the most important member of the health care team? DQ: Decision making and professional development

CASE STUDY 1

Grant Thompson was a fit 37 year old man, a father of two young children and married for 14 years to Georgina. Grant was a truck driver who was involved in an MVA 6 months ago and suffered extensive injuries to his leg and a mild head injury. His recovery has been slow and he relies heavily on the use of a wheelchair but can now walk for short distances with the aid of a walker. Georgina wants Grant to come home and rehabilitate there. She has made some modifications to their home, ramps put in, handrails in the bathroom and toilet.

The health care team is meeting to discuss this option. The team consists of the treating doctor, physiotherapist, and occupational therapist, NUM of the rehabilitation unit, social worker and psychologist. There is disagreement among the team as to whether Grant would be better to stay in hospital a bit longer or go home. The physiotherapist and the occupational therapist both feel that Grant still requires intensive treatment which can only be provided as an inpatient. The psychologist and the social worker have noted that Grant’s separation from his family and home environment has been having a negative effect on Grant, Georgina and their children. The treating doctor feels that we could treat Grant as an outpatient but it would mean he has to attend regular physiotherapy and occupational therapy sessions. You are the team designated leader of the health care team.

Discuss the following questions

1. What are the key issues in this dilemma?

2. What outcomes would be best for Grant and his family?

3. How would you guide the group in achieving this best outcome?

CASE STUDY 2

Norma Ellis is a 76 year old widow who recently had a fall at the nursing home she has lived in for the past 7 years and fractured her hip. She has subsequently had a hip replacement and has been rehabilitating well and is now due for discharge back to the nursing home. Norma has an extensive medical history including postural hypotension, rheumatoid arthritis and impaired mobility. She mobilised within the nursing home using a walker. Her son is demanding that his mother be kept in the ward as an inpatient as he feels the nursing home staff were negligent and wants his mother to be placed elsewhere but has not arranged this yet. The treating team consists of the doctor, physiotherapist, NUM of the rehabilitation unit, social worker and NUM of the Norma’s wing at the nursing home she was in prior to the fall. You are the designated team leader. The doctor feels there is no need to have Mrs Ellis on the ward as he feels that her rehabilitation has been maximised, this is an opinion shared by the physiotherapist. Norma wants to go back to the nursing home as she has made many friends there and feels at home there.

Discuss the following questions

1. What are the key issues in this dilemma?

2. How would you deal with Norma’s son? Are his objections warranted?

CASE STUDY 3

Robert Hughes is a 52 year old male who was injured in a bicycle accident two months ago where he suffered fractures to his (R) tibia/fibula and (R) radius. Robert is intellectually impaired and was living with his elderly mother until the accident. Robert has been known to engage in verbally aggressive outbursts towards staff and other patients. His mother who is now 75 years of age feels she can no longer look after Robert. You are the NUM of the rehabilitation unit that is admitting Robert for his ongoing rehabilitation. You are required to gather together a health care team to determine immediate and long term care options for Robert.

DQ: Decision making and professional development