February 2020

What would you do?

The following scenario demonstrates your accountabilities when you encounter a patient who has not received quality care, or your workplace is not supporting a quality practice environment.

Jane, a nurse, works in a health care facility where the patient population is mostly elderly patients with complex needs. During a shift, Jane notices that one of her patients has developed an open pressure sore on their buttocks.

Jane makes the patient as comfortable as she can, protects the wound and documents her assessment and interventions. Following her workplace policies, Jane notifies her team lead and gets an order to treat the pressure sore from the NP on the patient’s health care team. When Jane’s shift ends, she provides the incoming nurse with a report about this new development.

Jane thinks about the patient and why the sore was left to develop and not reported. She knows that at the facility many patients are left in bed for extended periods of time without being turned or moved to a chair. She believes that she and the other nurses are trying their best, but unless something changes a similar situation will happen to another patient. Realizing that the well-being of patients is at risk, Jane knows she has to speak up. She decides that she will advocate for her patients by bringing her concerns to her manager.

Jane speaks up for her patients

Jane meets with her manager and shares her concerns. Together, they brainstorm ways that the health care team could prevent pressure sores, including making sure patients are moved or transferred from bed more frequently. They discuss their available resources and the unique needs of their patients, and review what the best practice evidence says about pressure sore prevention. They identify some potential options that would work for both the patients and the staff.

At the next team staff meeting, Jane and the manger share their proposed plan for reducing the risk of pressure sores amongst the patients. The team shares their thoughts, and as a group, they refine the processes and identify how to put the new processes in place.

Putting patients first

When Jane brought her concerns to her manager, she was being an advocate for her patients. She met the practice standards by seeking assistance in a timely manner, taking action in a situation where her patient’s well-being was compromised and taking steps to create a quality practice setting at her workplace.

Jane and her colleagues also met the standards when they collaborated on ways to uphold safe patient care and protect patients from harm. These are all nursing accountabilities outlined in the Code of Conduct.

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