Bedside Management and Professional Boundaries

Question 1

Management tips

Answer 1

get report, start by reading history/physical, check recent labs, look at meds, perform head to toe, make schedule/set goals, chart as you go (in the room)

Question 2

Start by reading history and physical

Answer 2

what brought them in, meds, what have they been doing?

Question 3

Check recent labs

Answer 3

especially for trends, prioritization (ex: high wbcs, still high but lower = don’t freak out)

Question 4

Look at meds

Answer 4

schedule out - before meals, with meals

Question 5

Perform head to toe or focused assessment

Answer 5

usually second round, baseline for how doing today

Question 6

Making the most of your time

Answer 6

start planning meds when receive report (no multitasking), sinking ship, delegate, documentation, receiving report

Question 7

Sinking ship

Answer 7

be aware of who can help you, help others

Question 8

Delegate

Answer 8

find out who’s good at doing what

Question 9

Receiving report

Answer 9

active listening, don’t ask questions till the end

Question 10

Documentation

Answer 10

as early as possible, take notes throughout day

Question 11

What is something to be aware of with boundaries when caring for people you know?

Answer 11

could be overinvolved

Question 12

It is the __________ responsibility to maintain therapeutic relationship

Answer 12

nurse’s

Question 12

Professional boundaries

Answer 12

nurses are trusted, abstain from attaining personal gain at pt expense. maintain therapeutic relationship - not under or over involvement, careful w/ social media, sexual misconduct

Question 13

Red flags for boundary crossings

Answer 13

flirting, sharing personal info, keeping secrets, you’re the only one who can help, more time, pt asking about you

Question 14

Boundaries

Answer 14

space between nurse’s power/pt vulnerability

Question 15

Boundary crossings

Answer 15

for therapeutic purpose

Question 16

Boundary violations

Answer 16

for nurse’s need

Question 17

Nurse’s responsibility to maintain therapeutic relationship

Answer 17

no secrets, super nurse, role reversal, double blind, professional privilege

Question 18

Super nurse

Answer 18

I’m the only one who can take care of the pt

Question 19

role reversal

Answer 19

nurse using pt for satisfaction/gratification, pt taking care of nurse

Question 20

double blind

Answer 20

pt wants to terminate relationship but needs help from nurse so can’t

Question 21

professional privilege

Answer 21

nurse uses info learned for personal benefit

Question 22

bedside reporting

Answer 22

report at the bedside, pt feels part of the report, new nurse builds rapport with the family,

Question 23

Maintaining professional boundaries

Answer 23

clearly share role/limits, aware of vulnerable pts, keep personal/professional separate, touch appropriately, don’t overshare about personal life, be aware of your emotional response to pt, don’t friend on social media

Question 24

Nurses _________ buy/sell from a patient/family or be the power of attorney on their will

Answer 24

can't

Question 25

What are some ways to determine who gets what patients?

Answer 25

proximity, acuity, staff mix

Question 26

Patient safety (bedside reporting)

Answer 26

lay eyes on pt, decreased potential for near miss, they hear what's been said

Question 27

Top three reasons for bedside reporting

Answer 27

patient safety, patient satisfaction, benefits nursing staff, teamwork, ownership, accountability

Question 28

Patient satisfaction (bedside reporting)

Answer 28

they see nurses working together, feel more empowered/involved, become additional resource, pt want you at the bedside

Question 29

Benefits nursing staff (bedside reporting)

Answer 29

can prioritize care based on seeing, accountability between shifts

Question 30

Organizing information

Answer 30

ex: trifold, notes on what to tell next nurse. find one that works for you

Question 31

Hourly rounding

Answer 31

if you check on pts every hour they won't use the call bell

Question 32

What are the four Ps?

Answer 32

potty, pain, position, possession

Question 33

Hourly rounding helps prevent ____________

Answer 33

sentinel events

Question 34

Most sentinel events are from

Answer 34

lack of communication, insufficient pt education

Question 35

Tips to increase time at the bedside

Answer 35

document at bedside, plan ahead/have supplies with you

Question 36

Warning signs for boundary problems

Answer 36

excessive self disclosure, secretive behavior, special treatment, flirtation, overprotective behavior

Question 37

Document Head to Toe in pt's room

Answer 37

True

Question 38

professionalism

Answer 38

change from pt focus to nurse focus

Question 39

maintaining therapeutic relationship

Answer 39

be clear on role and care limits,

Question 40

cognitive impairment

Answer 40

history of physical or verbal abuse,