The scenario of Mr. J and his nursing care is an example of how not to treat patients, even if their demographic is not often seen in particular health organizations. From the beginning of the scenario there were many questionable actions that took place. The use of restraints could be an initial concern depending on whether or not they are truly necessary. It appears that Mr. J was restrained for quite a while given the red, depressed area near his spine. While his daughter inquired about it to the CNA, the CNA dismissed the area as if nothing serious was wrong. The CNA replied that the “sunburn” would go away once Mr. J was able to get up. There is no follow-up as to whether or not the “sub burn” disappeared.
Another issue that was observed in the scenario is probably the most concerning given that it involves the patient’s diet. It is clear that Mr. J’s diet needs to include only “regular, kosher, chopped meat.” It is learned that Mr. J. is Jewish, and kosher foods are part of his diet for his health as well as his culture. Well a day after his daughter visited him, he was served chopped pork cutlet. The most disturbing aspect was not the serving of the food to Mr. J, but it was rather the way in which some of the staff tried to cover it up. The nurse who notified her supervisor was told to not say anything and to keep the mishap under wraps. Coincidentally the next night when the daughter was present during her father’s dinner time, she received an apology about the mix-up in the food from a dietary worker. After being told this, the daughter asks the nurse of what happened, and the nurse simply replied, “Half a pork cutlet never killed anyone.” Even after the administrator, who happened to be Jewish, was eventually informed, it is revealed that the hospital has received similar complaints in the past 6 months. However, evidently nothing was done about the incidents.
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"Nursing Sensitive Indicators".
After analyzing the situation, it is obvious that nursing-sensitive indicators need to be addressed. Research suggests that “Developing nursing-sensitive indicators in the ambulatory care environment can highlight the contributions nurses make to patient outcomes” (Martinez, Battaglia, Start, Mastal, & Matlock, 2015, p. 59).
In addition to the use of indicators, it is important to also review hospital data incidence of pressure ulcers and prevalence of restraints. Pressure ulcers are related to the use of restraints. It is certainly obvious that Mr. J has been restrained for long periods of time in his hospital bed. According to Roberts, McInnes, Wallis, Bucknall, Banks, & Chaboyer there have been developments such as pressure ulcer prevention care bundles (PUPCB) in order to target both patients as well as nurses. The goal of these bundles is to lower the risk of pressure ulcers in patients while they are in the care of nurses. Kwong, Hung, and Woo believe (2016) “Pressure ulcers are not only an indicator of the quality of care in RCHs but also have a significant, negative impact on residents” (para 3).
In order to resolve this issue as an administrator who is concerned with care and ethics, I would certainly review protocol with my staff and provide training. The research suggests various trainings that would benefit the overall quality of care (Coleman, Nixon, Keen, Muir, Wilson, McGinnis & Nelson, 2016). However, the biggest concern that I have with this scenario is how insensitive the nurses are to their environments and the care of the patients. There is no reason why the well-being of a patient should be compromised due to a mistake. Nurses should be held to a higher standard than what they have shown in this scenario. Ethics is at the core of the issue in which patients are not provided with the utmost of care (Gopichandran, Luyckx, Biller-Andorno, Fairchild, Singh, Tran, Vahedi, 2016).
