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Nancy recently graduated from her nursing program 6 months ago and has been working on an orthopedic surgery ward. The ward recently lost 7 full time nurses and is still trying to make up for lost staff. Due to these shortages, many newer nurses like Nancy, have been oriented to Charge Nurse duties, a task that is usually reserved for nurses working at least 1 year on the floor. Nancy is working her first shift as a Charge Nurse when a patient becomes verbally abusive…

At the nurses station Nancy is checking patient’s lab results for the day

“Nancy”, another nurse approaches her, “the man in room 18B is verbally abusive and refusing to calm down. We have tried many approaches but he just keeps saying offensive things to us and now he is threatening to hurt himself”.

Nancy is alarmed; she has never encountered a situation like this on her own. She decides she will go down to speak to the patient.

“Mr. Jones, what seems to be the problem?” Nancy asks. “The problem is all your idiot staff and the fact that they wont take me downstairs to smoke and have a sandwich!”
Nancy knew Mr. Jones was a total hip replacement and would require staff with him at all times. She also knew the unit was very short staffed, and unfortunately it would be difficult to pull someone off the floor to accompany Mr. Jones.
Nancy started to explain this to Mr. Jones but he just became more agitated. Nancy quickly left the room and wasn’t sure what to do! One of the more senior nurses approached Nancy.
“I get it, you are new here, she said, but you really don’t know what you are doing or how things work, do you!?! Ugh they should have put ME in charge.”
Nancy was feeling more overwhelmed. She decided to call Mr. Jones’ attending orthopedic surgeon. She explained the situation to him on the phone, and was cut off mid sentence. “Now Nancy, you girls should know to give Mr. Jones special care and attention based on his situation. Do you need a man to come in there and take him downstairs for his cigarette?” the doctor chuckled. Nancy was feeling very overwhelmed and wasn’t sure how she was going to handle all these conflicts.

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