Medical Scenario #8

Disclaimer : This is not medical advice. This information is for educational purposes only. Always follow your hospital's policies, procedures, and guidelines.  Always consult with your hospital providers before doing any medical procedure on a patient. 

SCENARIO: 

You are starting your shift and are waiting to take bedside report. The RT who was supposed to hand off report to you in nowhere in sight. You call their phone but there is no answer. You are new to this NICU and don’t know anything about this RT. One of the nurses asks you if you checked the family sleep room? She states this RT sometimes disappears at night and goes to sleep in this room for hours. She is obviously frustrated. It is now 20 minutes past the time you were supposed to get report. You decide to look in the family sleep room and to your surprise, this RT is passed out. You wake them up and they sluggishly tell you they will meet you in the NICU to give you report. The RT meets you at the bedside, apologizes, gives you a short report, and leaves. 

& DISCUSS:  

What should you do at this time?  You are new to this NICU and don’t want to make enemies early on in your time there. This RT has worked at this establishment for 30 years and you worry that if you say something to a manager, this RT will retaliate against you. 

ANSWER: 

In this scenario, you're faced with a professional and ethical dilemma involving a colleague's behavior that directly impacts patient safety and the quality of care in the NICU. Here are steps you should consider taking in response to this situation: 

1. Ensure Immediate Patient Care Needs are Met: 

Before addressing the issue with the RT, your first priority is to ensure that all patients under their care are stable and have not been neglected. Review each patient's medical chart, check their current status, and ensure that any immediate care needs are addressed. 

2. Document the Incident: 

Document the facts of the situation as you encountered them, including the time you were supposed to receive the report, the time you found the RT, and the state in which you found them. Also, note the time and quality of the report you eventually received. Documentation should be objective and factual. 

3. Report to a Supervisor: 

After ensuring patient safety, report the incident to your immediate supervisor or the NICU manager. Explain the situation factually, without speculation or personal judgment, and provide any documented evidence you have. It's important that the issue is addressed by management to prevent future occurrences and to ensure the responsible RT receives the appropriate support or corrective action. 

4. Reflect on Patient Safety and Ethical Obligations: 

Reflect on the importance of patient safety and the ethical obligations of healthcare professionals. In the NICU, where patients are particularly vulnerable, the actions (or inactions) of each team member can have significant consequences. Consider what steps you can take in the future to advocate for patient safety and uphold professional standards. 

5. Seek Guidance: 

If you are unsure about the appropriate course of action, seek guidance from a trusted mentor or colleague with more experience in the NICU. They can provide advice on how to navigate the situation effectively and professionally. 

6. Follow-up: 

After reporting the incident, follow up with your supervisor or the NICU manager to ensure the matter is being addressed. It's also important to be aware of any changes or improvements in handoff procedures that may be implemented as a result of this incident to prevent future occurrences. 

7. Professional Development: 

Use this experience as a learning opportunity for professional development. Reflect on the importance of communication, accountability, and professionalism in healthcare. Consider how you might handle similar situations in the future and what strategies you can employ to promote a safe and effective work environment. 

Handling a situation like this with professionalism and a focus on patient safety demonstrates leadership and commitment to ethical standards in healthcare. It also contributes to a culture of accountability and safety in the NICU. 

Disclaimer :

Always follow your hospital's policies, procedures, and guidelines. Your hospital may have specific guidelines that you must follow. These scenarios are purely educational. Always consult with your hospital providers before doing any medical procedure on actual patients.