Josie King Story - Nurs 442 1

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Vianka E.

Nunez

Dr. Evette Wilson

NURS 442-001

23 May 2021

Josie King Story

1. What are the factors specific to Josie’s clinical situation that eventually led to her death?

The factors that contributed to Josie’s clinical situation that led to her death was severe
dehydration and misuse of opioids. I felt there was a lack of communication between the
doctor and nurses involved in Josie’s care. The reason I believe there was a lack of
communication is when the nurse gave Narcan to Josie and her mother made a comment
to the nurse saying the doctor put a hold on the opioids, but instead of the nurse verifying
the orders in the MAR to see if this was correct, she proceeded to give the medication and
informed Josie’s mother she was verbally told to give the medication. I personally felt
that the nurse was not advocating for Josie and her family because instead of clarifying
the order with the doctor to see if the restrictions were lifted, she relied on verbal orders
instead of written orders which is the correct way to follow orders and she did not take
Josie’s mothers concerns into consideration. Another scenario that resulted in a nurse
failing to be there for Josie is when her mother made a comment that she was not acting
like herself because if Josie would see water, Josie would cry and she even sucked on the
washcloth when she got bathe which is very alerting, but instead of the nurse assessing to
see why Josie was acting this way, she just told Josie’s mom that this is normal.

2. What interventions could have been engaged to prevent Josie’s death?


Some interventions that I would have done to prevent Josie’s death are:
- Performing an assessment on Josie when her mother reported that Josie was not
acting right because no one is going to know someone as well as their own family
member does
- Clarifying the opioid medication orders because verbal orders should not be relied on
unless if it is an emergency. In Josie’s scenario there was no sign of it being an
emergency so the nurse should have held the Narcan and contacted the provider to get
a written order on what exactly needs to be given if that verbal was correct before
giving any medication.
- When giving Josie fluids to treat her dehydration I wouldn’t have given a liter of
apple juice, instead I would use proper rehydration fluids to help hydrate her and I
would give it in moderate amounts to prevent overhydration toxicity
- Incorporate Josie’s family more in her care because as her nurse we are there for 12
hours, but it does not mean every single moment we are with the patient so any red
flags that the family sees I would take it into consideration and do interventions that
need to be done

3. How will knowledge of the Josie King story affect your practice?
My biggest take away from Josie King’s story is that it is important to always assess the
patient, avoid medication errors, and listen to family members when something does not
seem right. If I ever encounter a situation where a family member reports strange activity,
I will immediately assess the patient and if further actions need to be taken, I will contact
the provider. Before giving any medications, I will make sure there is a written order, I
will not follow any verbal orders unless if it is an emergency. Lastly, I will listen to any
concerns family has because sometimes they will be able to catch things that I may not so
seeing them as a apart of the patient’s healthcare team is essential.

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