You are a newly graduated registered nurse

You are a newly graduated registered nurse and have just started working on a medical ward of a large and busy hospital. You are on a morning shift and have just received handover and have been allocated your patients. Your patients have a high acuity and the shift is looking very busy. Your regular AIN that helps on the ward is off with Covid this week. The second patient on your morning round is Mr Frank Patterson, a 61-year-old man, who has a history of hypertension and gastroesophageal reflux disease (GORD). Frank smokes about 8 cigarettes per day and he is also overweight. When checking his vital signs, they are all stable and within range except for his blood pressure (BP) which is 175/97, but you can see that he has a modification for his clinical calling criteria which allows his BP to be anything equal to or below 180 mmHg systolic. When assessing Frank, he states that over the last day or two he has had quite severe reflux and chest pain, on and off. As you assess him further you notice he keeps rubbing his chest, looks a bit pale and also seems a little short of breath. You escalate your concerns to the nurse in charge and mention that Frank is complaining of reflux and looks uncomfortable. The nurse in charge seems stressed and tells you “he is always complaining about something and it is only his reflux playing up so don’t worry about it”. You are then called by another nurse to go do a drug check. Your shift seems to get busier and busier and you are rushing around trying to get everything done. Towards the end of your shift you hear the emergency button alarm go off and you realise it is for Frank, he has been found semiconscious in the bathroom and looking very pale and unwell, with severe chest pain and very SOB. The code team arrive. It is found that Frank has suffered a Myocardial Infarction. What should have been the first course of action taken by the nurse allocated to look after Frank and explain your answer. Discuss one core issue that you identified in this scenario that compromised patient safety. As a new RN you may be faced with this sort of scenario on occasion, a busy ward, feelings of stress and inexperience. On reflection discuss one thing the staff involved could improve on or do differently the next time this situation arises.

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