Risk Management (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 Our nursing background teaches us how to even through the nursing process, evaluate, evaluate, assess, evaluate again and see how it's working.

    00:14 So we want to make sure that whatever treatments we are going to be implementing, we are flexible enough that during our assessment if there needs to be a slight change, we're able to make that change.

    00:32 We want to make sure that that patient is at minimal harm to themselves and to others.

    00:40 We want to make sure that they have all the information they need to be adherent to medication, to our rules and regulations, and to the fact that we are there to help them towards recovery.

    00:57 That means that we never lose sight of the focus that we have on our therapeutic goal with them.

    01:06 It's not just our goal, it is our goal with them by talking to the patient, by gaining trust from that patient, by involving ourselves in a therapeutic engagement with the patient.

    01:22 And what do I mean when I say a therapeutic engagement for the patient? One of the most important things to keep in mind is therapeutic engagement means it's always about the patient.

    01:37 Oftentimes, it gets a little blurry, those boundaries might start getting crossed.

    01:43 You might think, "I remember when something like that happened to me." A therapeutic engagement is not going to say, "Oh yeah, I understand exactly what you're going through, that happened to me two years ago." Because what you've done is you've taken the spotlight off of recovery of the patient, and you started shining that spotlight on yourself.

    02:08 Therapeutic engagement says we are going to keep the spotlight on the patient.

    02:15 We are going to respect that person, that individual for who he or she is and understand that what they're experiencing is unique to them.

    02:28 And when we listen to what their story is and when we repeat back to to them what their story is.

    02:37 And if we are repeating back to them.

    02:40 And they say, "No, that's not right." We as nurses have the right to say, "Thank you so much for helping me get it right." Can you please help me? I want to get this right. I want to hear it from your side.

    02:55 Because otherwise, how can I advocate for you? I am there as a patient advocate.

    03:03 And if I don't know what the patient is trying to tell me, how can I advocate for that patient? This way, we are actually empowering the patient.

    03:17 And at the same time simultaneously protecting that patient.

    03:22 How does that work? A patient says to you.

    03:28 When I am home, sometimes my son hurts me.

    03:32 He doesn't mean it.

    03:34 He is you know, in his 60s, he gets very frustrated with me.

    03:40 And I'm in my 90s and I'm not moving as fast as he wants me to.

    03:47 And as the nurse, you can say, "What I'm hearing you say is that sometimes things happen where you don't feel safe." And let's see what I can do to help implement some boundaries and do some education so that maybe your son will understand you can't move as fast as you used to.

    04:16 That is protective empowering.

    04:20 If there is no abuse.

    04:22 If there is no abuse, then you are able to bring the son in and do some education.

    04:32 Find out if you need more resources in that home.

    04:35 Maybe the son is overwhelmed.

    04:38 Maybe you can get someone to come in a few hours a day.

    04:42 This is why we're thinking.

    04:44 When a person is admitted we're thinking about when they are discharged back into their environment.

    04:51 We want to have therapeutic engagement.

    04:54 We want to demonstrate respect for that person.

    04:57 We want to act as their advocate and we want to empower them while still providing some protection to them.

    05:07 Always we want to make sure that whatever we are doing is appropriate.

    05:12 It is within our legal and professional scope of practice.

    About the Lecture

    The lecture Risk Management (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Accessing Acute Psychiatric Care (Nursing).

    Included Quiz Questions

    1. The client
    2. Medication adherence
    3. The treatment team
    4. The primary nurse
    1. Provide the necessary education to clients and family members
    2. Assist clients in boundary settings
    3. Advocate for long-term admissions to prevent potential mistreatment
    4. Giving advice by describing how the nurse dealt with a similar situation
    5. Encouraging the client to bring a physically abusive family member in for mediation

    Author of lecture Risk Management (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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