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Dear AjoI enjoyed reading your post and found it quite interesting and thoughtful. I agree with your chosen challenges as the given scenario is posing these confronting situations. Undoubtedly, medication errors can cause harm due to wrong medication while being under the care of a medical practitioner, however, can be prevented in various ways. When undertaking medicines calculations and administration, the nurse must ensure that they follow national and local policies, procedures, and protocols, such as checking a calculation result with another healthcare practitioner. Especially, for controlled medicines, arranging for another healthcare professional to undertake a second check of dose calculations should reflect on nurses’ personal competence to address any deficits or uncertainty in medicines’ calculations, knowledge, and competence (Brindley, 2019). Moreover, it is within a registered health practitioner’s duty of care to practice quality use of medications, which includes taking all due care to ensure medicines are used judiciously, appropriately, safely and efficaciously (Nursing and Midwifery Board of Australia, 2019).There is a constant trust adhered to nurses to help patients in terms of medicine, and the confidence to make decisions. In the scenario, the nurse in charge should not have left Sarah with endone alone rather have asked for assistance, followed procedure and voiced opinion if something is wrong. Most people picture the nurse giving the wrong medication due to lack of focus on the tasks at hand, though medication errors can occur due to distractions as happened in the case study.On the other hand, I agree with your outlook on advance care planning which helps people to plan for their future medical treatment and end-of-life care in advance when they are healthy and able to make thoughtful decisions. Certainly, it enables individuals to express their wishes, priorities, beliefs, values and life goals to their doctors, family, friends, and carer before any healthcare crisis occurs as it happens in a clinical emergency in the scenario. Documentation ensures that patient’s preferences are known, understood and respected which influences the treatment and client-centred care and relives nurses from a dilemma. Indeed, nurses face the dilemma of being human, compassionate, and sensitive, in a work environment of many responsibilities. Situations discovered by professionals in patients, such as recovery or non-recovery, as well as the lack of capacity to deal with dark situations, such as death, can create a feeling of impotence and professional dissatisfaction (De Oliveira, De Alcantara, Vieira, & Do Nascimento, 2019). Therefore, ensuring that patients’ preferences are documented and easily accessible is important patient safety and quality improvement target to ensure patients’ wishes are honoured. Thus, documenting patients’ advance care planning wishes and having it readily accessible is essential to provide value-aligned care (Walker et al., 2018). In conclusion, documentation of bed 6 patient’s NFR orders would have helped to overcome family conflicts, relieved burden from family or healthcare teams to make decisions in stressful situations, improved patient and family satisfaction with care and treatment, and reduced stress, anxiety, and depression within the family.

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