Patient Care Management With An Example In Nursing Education

In nursing education, effective patient care management is a key learning objective. Educators often use scenarios to provide students with real-world examples to help them understand the complexities of managing a healthcare environment. This article presents a scenario-based learning approach focused on the distribution of patient care responsibilities and the implementation of care management strategies in a nursing unit. By examining these scenarios, nursing students can gain a comprehensive understanding of leadership, delegation, and the clinical decision-making process. Example In Nursing Education

Scenario for Patient Care Management in Nursing Education

Imagine you are the charge nurse responsible for establishing patient assignments for a 30-bed unit. The unit is staffed with four Registered Nurses (RNs), one charge nurse, and three Unlicensed Assistive Personnel (UAPs). Below is the breakdown of patient assignments for each RN on the shift:

• RN 1: 8 clients (all requiring routine care and discharge)
• RN 2: 6 clients (2 receiving blood transfusions; 1 new admission)
• RN 3: 6 clients (1 complex discharge, 2 beginning chemotherapy)
• RN 4: 8 clients (2 routine discharges, 1 recent postoperative patient)
• Charge Nurse: 2 clients (1 with a tracheostomy on a ventilator, 1 requiring routine care)

As the charge nurse, your task is to assign the UAPs to assist in managing the care of these clients. You’ll need to assess each client’s needs and the capabilities of your staff before making these decisions.

Client Scenarios

Client 1: Complex Ventilator Care

The charge nurse is responsible for Client 1, who has been on a ventilator for a year due to cerebral anoxia following a cerebrovascular accident. This client requires frequent suctioning, percutaneous endoscopic gastrostomy (PEG) tube feedings, and full personal care. Although the UAP assigned to assist is a senior nursing student with experience managing complex conditions, they are not as familiar with ventilators. Given the client’s stable condition, the UAP will provide morning care under the charge nurse’s supervision.

Teaching Moment: In this case, the charge nurse must consider the UAP’s skill level and provide clear instructions for care. Ensuring appropriate delegation is crucial for maintaining client safety, especially in complex care situations.

Client 2: COPD with Acute Exacerbation

Client 2 is under the care of RN 2 and was admitted directly from the doctor’s office with a diagnosis of COPD exacerbation and mild respiratory distress. The 89-year-old client is disoriented and has difficulty swallowing, though he can wash and feed himself with assistance. The UAP, who has been on the unit for three years and has experience with clients requiring similar care, will provide morning care, including assistance with activities of daily living.

Teaching Moment: The RN in this scenario must consider the UAP’s familiarity with the care required for clients with respiratory conditions. Effective communication between the RN and UAP ensures that the client receives appropriate care while allowing the RN to focus on more complex tasks.

Client 3: Postoperative Open Heart Surgery

Client 3, assigned to RN 3, is a postoperative patient following open-heart surgery. She was recently transferred from the cardiovascular intensive care unit after experiencing cardiogenic shock and ventricular dysrhythmias. She has a chest tube connected to 20-cm wall suction and is receiving 40% oxygen through a Venturi mask. The UAP, who has completed orientation but lacks experience with postoperative cardiac patients, will provide basic care under RN 3’s close supervision.

Teaching Moment: This scenario highlights the importance of assigning tasks based on the UAP’s experience level. The RN must closely monitor both the client and the UAP, ensuring that the UAP’s limitations do not compromise client safety. This type of scenario teaches students about the importance of supervision in clinical settings.

Implementation of Client Care Management in Nursing Education

The above scenarios serve as an example of how nursing education can simulate real-life patient management. Students are often divided into groups and asked to complete a decision-making exercise using tools such as the National Council of State Boards of Nursing (NCSBN) Decision Making Grid. This allows them to apply theoretical knowledge to practice while learning to prioritize care, delegate tasks, and make clinical decisions.

Classroom Strategies for Effective Learning

Group Activities: To implement patient care management effectively in the classroom, group-based learning is an essential strategy. The instructor should remain engaged with the students, moving among groups to offer guidance and support. Activities should be kept short, lasting 5 to 7 minutes, to maintain focus and prevent the group from losing momentum. Clear time parameters help keep the activity on track, and attention-getting devices like whistles can be used to bring the class back together for group reports or discussions.

Active Participation: Group activities, like the scenarios described, allow students to engage with the material and learn from one another. It is important to ensure that these activities connect directly with course objectives and cover material that is testable. Monitoring the volume of the group discussions helps maintain focus on the task at hand, preventing distractions and ensuring that students remain engaged.

Reinforcing Learning Objectives: Group work helps to foster a collaborative learning environment, which is particularly useful for complex topics such as patient care prioritization, lab interpretation, and conflict resolution. Case studies based on real-life clinical experiences provide students with the opportunity to apply their knowledge and skills in a supportive, controlled setting.

Group Thought as a Teaching Tool

“Group Thought” is a valuable strategy for cooperative learning in nursing education. By encouraging students to work together on complex tasks like interpreting lab results, setting care priorities, or determining appropriate nursing interventions, educators help build a strong foundation of clinical decision-making skills. Additionally, these activities foster rapport among nursing students, which can translate to stronger teamwork in clinical settings.

Conclusion

Scenario-based learning, combined with effective classroom strategies, plays an essential role in nursing education. It allows students to develop critical thinking and decision-making skills in a supportive environment. By simulating real-life patient care management, educators can prepare future nurses for the complexities of clinical practice, ensuring they are well-equipped to manage patient care, delegate tasks, and make informed clinical decisions. Incorporating tools like the NCSBN Decision Making Grid further enhances the learning experience, helping students connect theoretical knowledge with real-world applications.