You are a newly hired RN. A senior RN with many years ofexperience gives you an orientation and additional training on themedical unit to which you are assigned. Although you graduated froma baccalaureate program, there are several procedures with whichyou need to become more proficient. The senior RN is providinginstructions on these procedures and closely watches every move youmake.
One day you are providing care for Gina, a highly agitatedpatient who has been diagnosed with general anxiety disorder and isawaiting transfer to the mental health unit. The provider hasordered diazepam (Valium) IV push as needed to decrease anxiety.You and the senior RN agree that the patient is displaying acuteanxiety and requires medication. The senior RN instructs you to"push the diazepam IV" through a port in the IV tube near theinsertion site of the needle in the patient's hand.
You remember from one of your clinical sessions in the ICU thatthe only IV solution used when pushing IV diazepam is normalsaline, and it should be pushed through a large vein in the arm,not a small vein in the hand. The IV solution currently hanging onthe patient is D5W. When you question the procedure that the seniorRN has suggested, she says, "Look, this is how we do it here,missy. We are understaffed and do not have the time to switch theIV over to normal saline. When you push it in a port close enoughto the IV site, it doesn't matter what solution is hanging. If youwant to work here, that is how you will do it."
Questions:
1. How should you respond to the senior RN demanding themedication be given with the current solution?2. What are the possible consequences of administering themedication this way?3. What difficult behaviors is the senior RN displaying?4. Provide at least two strategies to communicate and work with thesenior RN during this scenario
You are a newly hired RN. A senior RN with many years of experience gives you an orientation and additional training on
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