2 working in the emergency department, communication literally means



5.2 Working in the emergency department, communication literally means life or death. If the wrong life saving medicine is given or the wrong amount due to a communication issue the patient could die. An overall problem in nursing is nurse to physician communication. It impacts job satisfaction and is found to be one of the leading causes of preventable patient injuries, complications, deaths, and malpractice claims (Hailu, Kassahun & Kerie, 2016). When it comes to patient care, the doctors aren’t caring for the patients as much as the nursing staff does. The doctor focuses on the medical aspect of the patient’s illness or disease process then determines the best course of action to treat the illness/disease. The nursing staff deal with the whole person and treat every aspect of the patients. The illness or disease process is but one piece of the puzzle in the whole person. What is going on in the patient’s life that is affecting their health and how can we improve patient outcomes to improve the overall whole person health. The problem of communication is seen throughout medicine on a daily basis and needs to be addressed and studied.

The overall problem is that nurses and physicians don’t communicate effectively in order to provide the best outcome for their patients. After the physician does the exam and orders the diagnostic tests, it is up to the nurse to manage pain, get all the essential information in the patients medical and social history. More times than not the physician goes back into the room or doesn’t after all the results are back and there is no communication with the nursing staff on what is going on with the patient. This leads to upset patients and the nurse looking bad for not having any info for the patient. The lack of communication does not promote a possible work environment and/or promote best patient outcomes. Effective communication can prevent patient injuries, medication errors, miscommunication, deaths, and legal complications later on. This is a well-known issue throughout the medical community and it needs to be addressed more in order to provide better patient outcomes and more positive work environments. Interprofessional collaboration is key to keeping patients safe and happy.


6.2 Pressure ulcers (PU) or pressure injuries (PI) are a condition that is an on-going issue within nursing. This condition occurs in several different patient care areas, medical surgical floors, intensive care units, emergency departments and operating rooms (Powers & Ames, 2018). Pressure ulcers occur in patients when they are confined to a bed for an extended period of time without being turned. “The PI occurs when direct pressure causes tissue ischemia in the skin, muscle, and fascia. This typically occurs over bony prominences, but also can occur in other locations” (Powers & Ames, 2018). When continued pressure is applied to the tissue, cutting off circulation resulting in necrotized tissue and ulcers forming. This topic should be studied because of the many variables that are involved in causing these ulcers to occur. Powers and Ames conducted research that identified key strategies to prevent the ulcers, which include, “repositioning patients to reduce the duration and intensity of pressure over vulnerable areas, avoid positioning the patient on bony prominences with existing nonblanchable erythema and use transfer aids to avoid dragging the patient while repositioning and reduce friction and shear forces” (Powers & Ames, 2018). In addition to the occurrence of PU happening in healthcare facilities, information gathered on the topic suggests a higher incidence rate in patients living at home, than in healthcare facilities (Meaume & Marty, 2015). Furthermore, research conducted by Meaume and Marty discussed the value of alternating pressure air mattresses (APAM) and feel the healthcare provider should choose to use the APAM based on evidence based or harm versus benefit and cost analysis (Meaume & Marty, 2015). The topic of PU or PI needs to be further studied for several reasons, these wounds occur in all venues of patient care facilities and the prevention methods vary considerably. Continued investigation needs to be conducted to identify the most pertinent prevention techniques to be able to provide the best care possible for PUs.

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