An Adverse Reaction To Medical Treatment A Clinical Situation

Question: Discuss about theAn Adverse Reaction To Medical Treatment for a Clinical Situation. Answer: Introduction: An 80 year old woman was admitted to a reputed hospital for the treatment of aspiration pneumonia. Upon reviewing her past medical history, she was found to be institutionalized in a nursing home for a prolonged period owing to multiple factors such as her increasing age, developing dementia, and her constant health issues. Her caregivers were not satisfied with the nursing home staff, as they felt that the woman was not constantly monitored, not even when she was eating, and she was left to fend for herself most of the time. Due to the carelessness of the staff, she was found to experience symptoms of choking breathing difficulty while eating, which was later diagnosed to be aspiration pneumonia. Her caregiver had previously reported such incidents in the course of her institutionalization, which unfortunately was passively dismissed. Upon hospitalization, she was administered an intravenous dose of Clindamycin for a couple of days. Upon her condition improving, she was discharged, with a follow-up regimen of 10ml oral Clindamycin liquid 4 times a day for 7 days. The patient did not turn up for the next two follow-up sessions which were scheduled for two consecutive weeks. Upon investigation, it was found out that she was in a very bad shape, dehydrated, with a severe bout of diarrhea. Two days later, she was reported to have passed away from severe diarrhea. Apparently, the caregivers had not informed the hospital about the patients death, and felt that the hospital was responsible for her death. This turned out as a severe shock to the hospital, who decided to review on her case to find out where things could have gone wrong, and who was responsible for the issue. The cause of the patients death was attributed to the adverse effects of the drug Clindamycin on the patients body. (Johnson, 1999) An Adverse Reaction To Medical Treatment The Aftermath The news of the patients death would have definitely come in as a shock to the hospitals healthcare staff involved in managing the patient. A lot of complicated processes and investigations would follow where in the staff silently becomes a second victim to the incident.(Seys, Albert, Gerven, Vleugels, 2012) TheImpact on the staff The news of the patients death would have definitely come in as a shock to the hospitals healthcare staff involved in managing the patient. Initially, the staff would panic, and express disbelief over the situation. The initial shock would give way to remorse, and they would berate themselves on not managing the patient properly. The staff would experience an emotional turmoil, with the apprehension of losing ones job, losing ones professional license, the financial and familial impact of unemployment, the possibility of involving in a lawsuit, and the reactions of the immediate community. (Wu, 2000) After subsequent happenings, and return to ones daily life proceedings, the individual would experience lack of self esteem, self-doubt, depression, symptoms of societal withdrawal and guilt. The psychological damage to the individual would be deep, and without any intervention, it could consume the individual. Though a few individuals have been able to put the past behind them and start on a new lease of life, a majority of the second victims have either quit their professions, or have taken up their lives. (Scott S. D., 2011) Role of other Staff in the Aftermath of the Event The staff who has committed a grave mistake leading to the patients death would immediate need reassurance by the peers, and her supervisors. She must not be treated at that point of time as solely responsible for the error, but as a human who has committed a mistake. Everyone concerned must remember that the staff has erred, and that it could happen to anybody. This particular staff would definitely have to face the consequences of her task, but letting an error of judgment affect her life would be very cruel, given that the psychological trauma which the individual faces would be very high.(Scott, Hirschinger, Cox, 2009) As a senior to the staff, the physician might let the staff describe her perspective of the incident, and validate what exactly went wrong, instead of taking her to task without letting her have any say on the incident. After all, there was no practitioner who has progressed without making any mistakes; they might have been just lucky to have escaped from serious issues. (Santomauro, Kalkman, Dekker, 2014) Deeper Impact of the Event An eventuality involving a clinical judgmental error not only affects the staff concerned, it also has a severe impact on the organization, its culture and dynamics. If the staff is relieved from her duties, there would be a general air of apprehension in the team, which would be an adverse influence on their confidence levels. If the staff continues, there would be a sense of awkwardness to interact with her; the situation would seem delicate. The trust on the staff would reduce exponentially, and certain challenges would not be allocated to her for a while. This would lead to increased feelings of depression and guilt in the staff. (Grissinger, 2014) Overall, the reputation of the staff and the hospital is in stake, as if the client decides to move a lawsuit against the hospital, the hospitals image would be tarnished. There is always the constant fear of negative projection by the media; what was a decent reputed hospital would be seen as an incompetent hospital, which would be detrimental for the hospital. Investigating and Reporting First of all, in an event like this, the staff that was in charge of the patient must be asked to give a report of the management of the patient, and must provide justification for each and every clinical decision taken. In this case, the adverse reaction of the drug presumably triggered diarrhea in the patient, leading to her death. The issues to be discussed are the rationale behind choosing the drug Clindamycin over other antibiotics, whether the age, physical and medical condition of the patient was considered upon administering the drug, whether the staff had considered the potential side effects of the drug on the patient, the correctness of the prescribed dosage, etc. (Treiber J., 2010) External investigations would be with the hospital management, on the staffs alleged error, and the Department of Pathology for the autopsy of the patient (which in this case was not applicable). The reporting must be done in a professional and unbiased manner, considering that the staff has no intentions to cause the incident, and that it was a human error. Supporting the Second Victims Whatever be the error on the part of the staff, he/she must be treated with respect and dignity as a healthcare professional. The staff must be immediately given psychological first aid, which is re-assurance, an opportunity and space to vent out their emotions, and a listening ear, to be able to listen to their feelings of emotional turmoil. This would help the staff get into terms with the situation, cope with depression, and prevent suicidal tendencies. The support of the staffs immediate family and society is much needed during the initial stages of the incident.(Decker, 2012) They must be empowered, with a renewed opportunity to work and utilize their skill in healthcare service. A lot of budding talent and a huge expertise have been lost due to the staffs quitting from his/her profession upon committing an error. They must be encouraged to work, by trusting them; this would help them get back on to their feet.(Burlison, Scott, Browne, Thompson, Hoffman, 2014 ) Role of Second Victims iPreventing Adverse Events Only a person who has committed a mistake would know the pain of its consequences, and the emotional turmoil associated with it. A second victim, who has decided to put the past behind, would possess a great deal of additional responsibility, in order to not commit any serious error in the future. She would have a great sense of empathy, which would hone her professional skills further, and make her more caring and approachable. A person who has made a mistake would be an efficient guide to other staff; and if she feels comfortable could quote herself as an example to other staff, thus reminding them to be extra careful in their work. She would naturally set the bar higher, in order to provide sincere and dedicated service to the patients in future.(Scott Hirschinger, 2009) Second victims are the unknown, unseen and unspoken people whom we often encounter in our daily lives. Whatever might be their error, treating them as humans would go a long way in restoring their faith in themselves, and in humanity. References Burlison, J. D., Scott, S. D., Browne, E. K., Thompson, S. G., Hoffman, J. M. (2014 ). The second victim experience and support tool (SVEST): Validation of an organizational resource for assessing second victim effects and the quality of support resources. Journal of Patient Safety . Decker, S. (2012). The Second Victim. Griffith University. Grissinger, M. (2014). Too Many Abandon the Second Victims Of Medical Errors. Pharmacy and Therapeutics , 591592. Johnson, S. S. (1999). Epidemics of diarrhea caused by a clindamycin-resistant strain of Clostridium difficile in four hospitals. 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Medical error: the second victim - The doctor who makes the mistake needs help too. British Medical Journal , 726727.