Case Summary

The client, an older woman, with a fractured right arm and living with multiple chronic conditions (hypertension, arthritis, diabetes), lives on her own in subsidized housing and is being prepared for discharge when an internationally educated personal support worker (PSW) notices the client’s condition is deteriorating. The PSW attempts to notify the charge nurse, but the charge nurse ignores the PSW’s comments, as she herself had observed the client as stable and ready for discharge. After 10 minutes the charge nurse decides to assess the patient and finds the patient in distress. This finding of deterioration requires an urgent call to the medical team resulting in delay in discharge pending further workup from the medical team. Conflict between the charge nurse and physician in-charge occurs in planning for the patient’s discharge. Further, a nurse on the unit became ill and has gone home for the day. The unit is now short-staffed and other nurses on the unit have become frustrated with having to take extra patients. Note: the Charge Nurse (CN) is a rotating role where nurses take turns acting as the CN.

Note to Faculty: This simulation can be used as individual scenes or sequentially depending on the focus and time available. If used sequentially, each scene builds on the previous scene by adding to the complexity of issues the CN will encounter throughout the shift.

While watching scene 1, students can reflect on and  consider how the characters demonstrated specific leadership behaviours (e.g., transformational, complexity, collaborative or clinical leadership). What interprofessional competencies were reflected in the scene?