CASE STUDY DETAILS:
Wisteria Village is a not for profit 80-bed facility (which includes a 15-bed dementia unit) located in the centre of town. The Village also has 25 independent living units onsite.
You are the Registered Nurse – you started at the facility seven months ago after completing your degree and started working night shift four weeks ago. The staff and consumers have made you feel very welcome as a new graduate and you feel well supported by the management in your role.
Rachel is the facility manager and David is the clinical care coordinator, they are both available to you via their work mobiles.
Your night shift at Wisteria Village commences at 2200 hours. Tonight, you are working with:
Anna, an Enrolled Nurse who completed her Diploma of Nursing two years ago and has worked in the facility since completing her degree.
Kim, an ECA (extended care assistant) who has worked in the facility for the past 23 years. All the residents know Kim very well and she is highly respected by the consumers and the management of the facility. Kim has completed a Certificate lll in Individual Support (Ageing, Home and Community).
Fred, an ECA who works as a casual employee, he also works part-time in the community (working with consumers as an ECA in their own homes). Fred has completed a Certificate lll in Individual Support (Ageing, Home and Community).
Ruby, a second-year Bachelor of Nursing (BN) student from the University of Tasmania.
The shift begins with the normal routine, you are aware from handover that Mrs Peterson is receiving end of life care, her daughter and granddaughter will be staying the night with her. On your medication round you check on her, you note her extremities are cool to touch and her breathing is irregular, and her eyelids are half open.
At 0210 you respond to a call bell for Mrs Lee – she is complaining of sore knees and requests some paracetamol, her Voltaren gel and a hot pack. Your pain assessment confirms that this would be a suitable management strategy as you are aware this has provided relief in the past. Mrs Lee is an impatient resident who becomes verbally abusive if she is kept waiting.
On your way to the medication room, Kim comes to inform you that Mr Lloyd is not is his room and he has searched nearby and can’t locate him. You know that Mr Lloyd often gets up at night, he is a very thin man who mobilises with a walking stick. He has Parkinson’s disease and has type 2 diabetes.
During your conversation with Fred, Kim phones you from the secure unit to say Miss Bell is on the floor next to her bed, she informs you that she doesn’t appear hurt but Kim can’t get her up off the floor.
You also note that the call bell from Mrs Peterson’s room has been activated. Anna responds to the bell and returns to tell me Mrs Peterson has died and her daughter is very distressed.
As the Registered Nurse in charge of the facility on this shift – what is your plan of action? What are you going to do and what are you going to delegate to others?
You need to consider:
Scope of practice
Legislation and any mandatory reporting requirements
CASE STUDY DETAILS: