An event that was meaningful to me as a nurse happened during my clinical time at St. Michael's Hospital when I did not wash my patient before 8:00 am in order to prepare her to go to a plastic surgery appointment later on that day. My patient's 10:00 am Heparin administration was delayed by 45 minutes because she was being washed at that time. This event occurred because I did not prioritize the tasks I had to complete during the day properly, and therefore I learned the importance of time management while I work as a nurse on the clinical unit.
Besides me, the people who were involved in the event were the registered nurse who I shadowed, my clinical instructor, and my student nurse buddy. At the beginning of the clinical day, while the events happened, I contacted my instructor, my nurse, and my student nurse buddy. The nurse and I sat down to look at the Kardex of patients and wrote down notes on our Personal Organizational Plan (P.O.P.). On the Kardex, my patient's condition was the same as yesterday except she would have a plastic surgery appointment later on that day. Usually the patient's husband would visit her daily around 9:30 am and provide care which including washing the patient and helping her to perform bowel elimination. My patient preferred that nurses leave them alone while her husband cares to her. On this particular day, the patient's husband had an appointment and could not visit his wife in the morning, which meant it was my responsibility to wash my patient early so she could be ready for her appointment. I verbally informed my student nurse buddy that I would need her help to wash my patient but I thought my memory was good enough that I did not have to write down this specific task on my P.O.P. When I met with my patient, I concentrated on measuring her vital signs, completing the initial assessment, nursing activities, and interviewing my patient for the Roy Care Plan assignment as these tasks were originally listed on the P.O.P. I made sure I finished charting by 9:00 am. Once I finished charting, the nurse came up to me to see if I had bathed my patient and I replied no. From the nurse's unsatisfied facial response, I realized I should have bathed my patient earlier in advance. My clinical instructor also asked my student nurse buddy and I the reason the patient had not been washed yet. I thought I could have washed my patient after I completed the charting as I knew the patient usually was washed around 10:00 am by her husband. I felt really bad and irresponsible because I did not wash my patient on time and prepare her for the appointment. My intuition told me there must be an essential task I had missed, but I just could not recall what it was since I did not write it down on the P.O.P. I thought my clinical instructor and the nurse must feel disappointed that I did not perform the task earlier as I remembered my clinical instructor stated clearly to check if any of our patients has special orders or tasks to be done at the beginning of the shift. I believe there are ethical and economic considerations to be taken into account about this event. If my patient was still in the process of getting ready while she received a call to go down to the plastic surgery unit, it would create unnecessary wait time for the plastic surgeon and other patients who would see the plastic surgeon later on. In order to compensate for the extra wait time, staffs at the plastic surgery unit may try to rush things and quality of treatment that patients receive may suffer. Staffs may have to work overtime due to the delay and economic burden would be a result. In addition, delay of administering Heparin will increase patient's risk of blood clotting and serious consequences such as pulmonary emboli, myocardial infarction, and deep vein thrombosis may be resulted. This will be considered as maleficence to the patient (Potter & Perry, 2009). Moreover, I believe I should be accountable to my patient by providing safe and quality care to my patient which includes washing my patient on time. This belief arises from my nursing teachers constant reminders to us that it is very important to follow CNO's practice standards during practice.