Answered: "I'm concerned, I'm uncomfortable, and…

Principles Of Pharmacology Med Assist

6th Edition

ISBN:9781337512442

Author:RICE

Publisher:RICE

Chapter10: Medication Administration Essentials

Section: Chapter Questions

Problem 23RQ

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The surgery was a planned caesarian section. Delivery of the baby via C-section was uncomplicated until it was time to close the patient. The attending had left the OR and let the fellow and resident take over the case. The circulating nurse informed the doctors that a pad was missing. The fellow and resident were very sure of themselves and insisted that the nurse had counted wrong and went on and closed the patient up. Two days later, the patient became hypotensive and febrile and complained of sharp abdominal pain. A flat plate of the abdomen revealed a foreign object left inside of her. The circulating nurse should have spoken up using CUS with the doctors, stating, "I'm concerned, I'm uncomfortable, and closing her up without accounting for the missing pad is unsafe." The two-challenge rule should have also been invoked when the initial concern was ignored. The nurse should have voiced her concern twice to ensure she was heard. The doctors should have acknowledged her challenge and asked the nurse to perform another pad count with another nurse or one of them. Once the pad count was off the second time, the doctors should not.

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