Question: Could This Conflict Have Been Prevented? Mr. Jones, a 49-year-old automobile salesman, was admitted with severe back pain. As his primary care nurse, you have established a rapport with Mr. Jones. He has a type A personality and has been very critical of much of his hospitalization. He was also very upset by the level and duration of his pain following his laminectomy. You agreed to ambulate him on your shift three times (at 4:00 PM, 7:00 PM, and 10:30 PM) so that he would need to be ambulated only once during the day shift. He does not care for many of the day staff and feels that you help to ambulate him better than anyone else. You noted the ambulating routine on his nursing orders. Yesterday, Joan Martin, a day nurse, believed that his bowel sounds were somewhat diminished. She urged him to ambulate more on the day shift, but he refused to do so. (The doctor had ordered ambulation q.i.d.)
When Mr. Jones's physician visited, Nurse Martin told him that Mr. Jones ambulated only once on the shift. She did not elaborate further to the doctor. The physician proceeded to talk very sternly with Mr. Jones, telling him to get out of bed three times today. Nurse Martin did not mention this incident to you in the report. By the time you arrived on duty and received the report, Mr. Jones was very angry. He threatened to sign himself out against medical advice. You talked with his doctor, got the order changed, and finally managed to calm Mr. Jones down. You then wrote a nursing order that read, "Nurse Martin is not to be assigned to Mr. Jones again." When Joan Martin came on duty this morning, the night shift pointed out your notation. She was very angry and went to see the head nurse.
ASSIGNMENT: Should you have done anything differently? If so, what? Could the evaluation of clinical performance by you and Nurse Martin have been done in a manner that would not have resulted in conflict? If you were Nurse Martin, what could you have done to prevent the conflict? Be able to discuss this case in relation to professional trust, peer review, and assertive communication.