Identifying a Deteriorating Patient

Question: What are some of the complexities in identifying a deteriorating patient? Answer: In the present case study, the lack of use of rapid response systems for the deteriorating health f Sofie, are a major drawback (Massey, D., Aitken, L. and Chaboyer, W. 2010). Due to this factor majority of the time is wasted in waiting for the results of the CT scans and other tests and scans ordered for the patient. Secondly, another problem is taking care after ceasing the sedation of the patient. Although sedation is a critical component for preventing sleep, anxiety, agitation, etc, daily interruption of sedation decreases the duration of the mechanical ventilation, shortens the stay at the hospital and when combined with simultaneous breathing trials, may improve the outcome of the patient (Helbok, R. Badjatia, N. 2009). However, the rationale for rapid awakening strategy by giving general anaesthesia is that it is essential to conduct and diagnose the postoperative neurological complications in order to restrict the potentially devastating consequences and thereby aiming to i mprove the patient outcomes. The problem here is the situation in which the patient does not come back to his/ her senses and there is failure of attempt to perform the neurological evaluation (Fabregas, N. Bruder, N. 2007). Another problem with the deteriorating patient is the informed consent. In this case, The doctors find it necessary to tie the arms and hands of Sophie as they are fidgeting with the medication procedure. But the problems posed by the family members not only interrupt the treatment course but also create a stressful environment for the patient and the doctors. Informed consent is a topic of discussion between the patient and the physician. There are cases when the decision of the patient is not agreeable to the doctors and vice versa, but as doctors/ nurse, it is our responsibility to inject our own sense of values in the process of decision making and therefore reach to a conclusion (Terry, P. 2007). Some of the other factors that introduce complexity in the treatment and identification of a deteriorating patient are the lack of experience and flexibility of the staff, availability of the nurse initiated monitoring, lack of access to the resources of knowledge, etc (Gazarian, P., He nneman, E. Chandler, G. 2010). The distinguishing proof and administration of patient crumbling needs to be taught in expert advancement projects joining high loyalty reenactment procedures (Cooper et al. 2012). References Cooper et al., 2012, Managing patient deterioration: assessing teamwork and individual performance, Emerg med J. Fabregas, N. Bruder, N., 2007, Recovery and neurological evaluation, Clinical Anaesthesiology, Vol. 21, no. 4, pp: 431-447. Gazarian, P., Henneman, E. Chandler, G., 2010, Nursing decision making in the prearrest period, Clinical nursing research. Helbok, R. Badjatia, N., 2009, Is daily awakening always safe in severely brain injured patients? Neurocritical care, Vol. 11, no. 2, pp: 133-134. Massey, D., Aitken, L. and Chaboyer, W., 2010, Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient? Journal of Clinical Nursing, Vol. 19, no. 23-24, pp: 3260-3273. Terry, P., 2007, Informed consent in clinical medicine, Medical ethics, Vol. 131, no. 2, pp: 563-568.