Mrs. Walsh Repeat Coronary Artery Bypass Craft
Order ID: 89JHGSJE83839 Style: APA/MLA/Harvard/Chicago Pages: 5-10 Instructions:
Mrs. Walsh Repeat Coronary Artery Bypass Craft
Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our
institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for
several weeks before her death. Her family was very anxious because of Mrs. Walshs unstable and deteriorating
condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very
anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to
ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac
surgeon to better inform the family of their mothers status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with
Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was
receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related
that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with
lists of questions. A consistent group of nurses who were familiar with Mrs. Walshs particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She
broke that tradition when she responded to the sons and the daughters helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires
knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with
families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes
okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, Why are you doing this? Nurse So and So does it differently. She commented that nurses learn to be flexible and to
reset priorities. They should be able to let some things wait that do not need to be done right away to give the family
some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see
what times worked best for them; then she posted family time on the patients activity schedule outside her cubicle to
communicate the plan to others involved in Mrs. Walshs care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done inthis unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They
turned down the lights, closed the doors, and put music on; the nurse, the patients daughter, and the patients son all
cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines
and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was
with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter
should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them.
This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a
paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking,
increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing
colleagues who may question your inclusion of the family in care?
3. Using Benners approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.’Mrs. Walsh Repeat Coronary Artery Bypass Craft
RUBRIC
Excellent Quality
95-100%
Introduction 45-41 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Literature Support
91-84 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Methodology
58-53 points
Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score
50-85%
40-38 points
More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.
83-76 points
Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.
52-49 points
Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality
0-45%
37-1 points
The background and/or significance are missing. No search history information is provided.
75-1 points
Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.
48-1 points
There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
You Can Also Place the Order at www.collegepaper.us/orders/ordernow or www.crucialessay.com/orders/ordernow Mrs. Walsh Repeat Coronary Artery Bypass Craft
Mrs. Walsh Repeat Coronary Artery Bypass Craft