Question 1: Think of a surprising or challenging practice situation in which you felt underprepared, unprepared, or uncomfortable.
In a particularly challenging situation, I was assigned to care for a patient who had been admitted following a stroke. The patient had a pacemaker, preventing the use of MRI to determine the stroke’s exact location. Over several nights, I monitored her condition. On the fifth night, I noticed the patient had developed a fever of 100.5°F since the morning, but no interventions had been implemented. Upon assessment, she was lethargic and unresponsive to verbal stimuli, a significant deviation from her baseline. She exhibited no acute distress, but I detected crackles and wheezing in her right lung during auscultation. Despite my concerns, the on-call doctor deferred any immediate action until morning. After escalating the issue to the charge nurse and nursing supervisor, the necessary orders were finally placed. Subsequent tests revealed a urinary tract infection (UTI) with E. coli and pleural effusions, requiring thoracentesis. This experience underscored my feelings of unpreparedness in advocating for timely medical interventions.