NUR 283 Journal - Safe, Patient-Centered Care

Safe, patient centered care is the most important aspect of nursing. We have been conditioned to think “safety” with every decision we make, safety, safety, safety, especially since we are the ones caring for the patient. Our job is to care for them, educate them, advocate for them, and aid in their recovery. The only way we can do any of this, is by making their safety our top priority. In a recent course, we had a clinical that had primarily elder patients that needed a lot of safety protocols implemented. This meant checking bed alarms, fall mats, educating the patient about what they need to do whether it’s using a walker, how to use a call button, or even taking sips of water between small bites. This was also extremely important information to include in hand off reports where the nurses can explain the patient’s situation and communicate on how we can optimize their safety according to their current physical, mental, and emotional state. An experience I had that really stood out is with an elder patient that had dementia. She had been their long term and was of minimal concern regarding around the clock supervision. She was prompt in using her call light, which she rarely did since her family was often there. The patient was Hispanic, and her family played a huge role in her care which is tradition in the Hispanic community to care for their elderly. The family also sometimes translated for her because the patient sometimes spoke in Spanish when she was having moments of forgetfulness. We would soon find out that this trust that was had in the patient and how comfortable we were with trusting her. On day shift, the day before our clinical, the patient’s family was not there like they usually were, as they also had lives and things to tend to, understandably. The patient was in bed, the wheels were locked, and the bed was lowered. What wasn’t done cost the patient her life. The patient got up without using her call light, likely because she was confused and due to this trust the nursing staff had in this patient, she was not checked on as often as she should be. She had fell and was found face down on the floor. She had died later that night. I found this to be extremely preventable, and although I was not her nurse, or there during the incident, I felt responsible for the carelessness that led to this patient falling. I had heard about this patient through hand off the next morning, and the way it was explained was so shocking and I felt as though the safety of this patient was the least of their concerns. The nurse giving hand off stated “We found the patient face down, ass up.” In a light, playful manner. The carelessness and lack of empathy and responsibility was heart breaking, and just goes to show that good nurses are the nurses that care about their patients and put safety above all. The thing I would have changed if I were the nurse at the time, would be to check on the patient more often, and perhaps use a translator that would translate for the patient regardless of if the family was there or not. We should always check on our patients and put the patients that often became forgetful on top of our safety priority list. Since the patient’s bed alarm was left off, it could’ve meant this patient was lying on the floor for a long time. And it could have been prevented by the nurse doing hourly checks and ensuring that all safety measures were checked, including turning the bed alarm on, and ensuring the patient had everything they needed that would potentially be the cause of them getting out of bed.