Healthcare thinking it through questions.


Marlow Barrons is a nurse on vacation in Alaska. After fishing all day, she and her friends are unloading their boat when an emergency call comes to the Coast Guard. She overhears them discussing that a professional fisherman has amputated his arm in the gears of his boat. She tells them she is a nurse and offers assistance. Her offer is accepted, she boards the Coast Guard boat, and they speed off to the site of the accident.

What signs and symptoms can Marlow anticipate seeing based on the report of the accident?

What type of first aid should she anticipate the victim will need?

Are there special considerations regarding the amputated arm?


John Street is a health care student and is feeling the need to get away from the stress and routine of studying. He decides to take a hike in the local mountains with his friends. As they ascend the mountain, it gets cooler and begins to rain. One of the hikers, Paul, starts to lag behind. Paul has always been a slower climber, so they continue on. A little while later, John turns around to see how Paul is doing and can no longer see him. John backtracks and finds Paul sitting beside the trail. He is shivering and his skin is cold to the touch. Paul says he is just very tired and needs to rest for a while and that he will catch up later.

Should John leave Paul to rest by himself?

What may be happening to Paul?

What first aid, if any, should be given to Paul?


Lack of information and failure to communicate are common causes of workplace conflict. Hank Stuart is experiencing a situation that really has him upset. He is a physical therapist assistant at a busy sports medicine clinic. He also has an interest in computers and worked in a large computer retail store while he went to school. It did not surprise Hank when one of the owners of the clinic, Kathy Chin, asked him to gather information about computer systems and software that could be used for patient management. Hank spent several hours of both work and personal time and gave his recommendation last week. It was then that he discovered that a system had already been purchased. The clinic’s other owner had assigned the computer research task to another employee. Upset that his time and ideas were wasted, Hank has let everyone know just how disorganized and unfair his employers are. His coworkers are tired of hearing about it and wish Hank would just forget it.

Do you believe that Hank’s reaction to the situation is appropriate? Why or why not?

How can he better deal with the situation?

What action would you recommend that he take?


Fran Nichols is angry. She can’t believe what happened at work today and how unfairly she was treated by her supervisor, Dan Watson, RN. Dan has been on her case from the beginning, always criticizing her work. But she never thought he would actually fire her. Working an 8-hour shift as a nursing assistant is hard work, and it only makes sense to take some shortcuts to complete all the duties. The safety precautions that Dan insisted on were very time consuming and really didn’t seem necessary. After all, the patients she worked with didn’t have acquired immunodeficiency syndrome (AIDS) or anything, so it didn’t really make sense to go to so much trouble with gloves and special waste disposal and so on.

Based on the information given, do you believe that Fran’s dismissal was fair? Explain your answer.

What would you advise Fran if she wants to continue to pursue a career in health care?

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