Nursing Leadership

RUNNING HEAD: NURSING LEADERSHIP
NURSING LEADERSHIP
Name of Student
Name of University
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1NURSING LEADERSHIP
PART 2
The attending nurse cares for a recovering coronary artery bypass surgery patient who
had his surgery two days back. His eyes are swollen and the nurse attends the patient when
his family has come to visit him. The assessment is about to be taken and the nurse is worried
about the outcomes and findings and she strives through the moment of truth. She thinks of
the complications that might be found out or not may be but a CABG patient has to but tested
for a lot of post-surgery complications and the progressive prognosis rates.
Being a registered nurse, I feel autonomy, beneficence and non-maleficence are the
most important nursing principles that should be practiced with full integrity even under
dubious circumstances. The patient who had undergone a coronary artery bypass surgery is
like to develop cardiovascular complications and respiratory problems. But as a nurse, when
she showed tremendous critical thinking skills and rationalized the non-wakefulness of the
patient or non-responsiveness of the patient to light stimulus – with the effect of poisoning.
Nitro- prusside which is often administered as an antihypertensive drug and also after
surgeries to reduce internal bleeding complications. But too much of nitroprusside levels in
the patient’s body can lead to poisoning and neural non-responsiveness which most of the
experienced clinicians, doctors and nurses alike are likely to miss. I feel the same way about
it that critical thinking, parallel thinking, applying the rationale while monitoring and
assessing patient symptoms along with drawing of a correlation and doing an instant analysis
of the situation is pertinent to a clinical decision making. The patient situation is a resultant of
pathophysiological signs and symptoms and to discriminate between a sign and symptom –
takes a lot of practice and experience but being a nurse, it is important to be open sighted,
astute and patient centered all the time and that’s what the nurse in the story has done it
exactly, she was completely oriented to the patient and the neurologic signs which went
unsighted or unnoticed even by the cardiologist. It shows a very deep aspect of medical care

2NURSING LEADERSHIP
underpinnings that in spite of an existent knowledge gap between nursing and medical
education globally – critical analytic skills and application skills are very individual things
and cannot be determined solely with the level and nature of medical education received. The
story is a strong illustration of how health practice should be undertaken with proper decision
making and totality. This is the reason why now in many healthcare settings, trans-
disciplinary collaboration is promoted to increase the viability and utility of ‘shared
knowledge’ in a clinical environment. The nurse in the story after getting disallowed by the
attending cardiologist for a CT scan or thiocyanate check – she retained her nursing
(professional) beliefs and personal beliefs which is great display of professional integrity and
patient centered care. Even though there are a hierarchical system in healthcare
administration (Rodon, & Silva, 2015) where doctors are given majority of the authorities,
the nurses still (such is the nature of their work) manage to spend most of time servicing and
caring for patients. The nurses are the reason that a planned pharmacological (Ferrell et al.,
2016) and pre – post and peri-operative surgical care could be delivered to the patients and
the way the nurse in the story takes up the responsibility of protecting the patient from any
sort of complex life threatening situations – is quite stirring and moving for a fellow nursing
professional like. She single handedly handles the severe condition of patient by directly
calling up the Tucson Poison control and getting a toxicity test done. The toxicity test
revealed the consciousness loss of the post coronary artery bypass surgery patient was due to
nitroprusside which was administered to the patient for hypertension. Finally, the nurse got
her doubts confirmed by the poisoning finding and she saves the patient from death or near
death paralytic complications which are so common due to missed clinical care and
neurological impairments. These hospital acquired complexities and increase in morbidity-
mortality rates due to deficient clinical care and non-adherence to best practice guidelines –
are so very common. But individual skills, individual commitment and individual adherence