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Case Study: a new graduate nurse assigned to a 65-year-old client admitted from home with an infected stage 4 decubitus ulcer of the sacrum. The client also has decubitus ulcers in varying stages of healing throughout the body. The client is well known to the hospital staff and has frequent admissions to your unit. During this admission the client has required multiple blood transfusions, a warming blanket/Bair Hugger and heat lamps to maintain a normal body temperature, several doses of 50% dextrose intravenously to maintain a normal blood glucose and numerous fluid boluses to maintain a normal blood pressure. The client is a full code and the family refuses to sign paperwork to change the client's status to do no resuscitate (DNR). The family also refuses to send the client to a skilled nursing facility stating "We want to take care of Daddy at home."
One of the unlicensed assistive personnel (UAP) knows the family outside of the hospital and states that the daughter that he lives with does not work, but just bought herself a new car. The UAP suspects the family is keeping the client alive for his retirement pension.
Soon after this conversation, the daughter comes into the room while you are changing the dressing on the client's sacrum. She is verbally abusive towards you and states "You haven't been a nurse that long. You don't know what you're doing. I am going to tell your manager and make sure you get fired." She then leaves the room and hospital.
Questions:
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