The ability of the nurse to effectively advocate for the patient lies within the nurses competency of the situation at hand and the level of care needed by this patient. We must make sure that what is asked for by this patient is safe, and that this care can continue as they transition to the next level of care. If at all possible, we must engage a competent individual who will see to it that this care is carried out for the patient safety regardless of where they are transitioned to. We must give these patients a chance to participate in their care by educating them of their disease process, and recovery potential. They must be willing participants toward their recovery and hence improving their quality of life. We are to do all in our power to protect their rights and make every effort to eliminate errors. We must make sure their medication orders are without errors, and also see to it that they have all the resources they will need by helping them find outside resources. Their awareness of their community resources will greatly benefit them and help toward the improvement of their well beings.
Two days ago, I was involved in the care of an oncology patient. She was no longer able to speak and was becoming vividly altered in mentation. She had been alert and oriented in the previous week, but at the shift report on this day, I was informed that she had climbed out of bed and fallen. When I got to her, I discovered that her condition was becoming more acute and she was hallucinating and declining fast. I made the Charge nurse aware of her increasing anxiety and inability to stay in bed, requesting for a sitter to keep her safe, I was told that we had no resources and that I should consider using a posey restraint or ativan to settle her. My lady is 91 years old with acute alteration in the mental status due to her disease process, the last thing I wanted to do was to increase her anxiety with the posey, I did not want to end her life either by giving her ativan. She was severly anorexic and receiving PPN due to her NPO status. I went and stayed in her room and attempted to run to my other patients from there. I was finally able to consult with the shift coordinator who subsequently provided me with a sitter for this patient. She lasted the night with a 1:1 sitter, without exotic drugs and received the care she needed.
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