A patient developed a rash from a now medication, unbeknownst to the medication nurse, who never risked about any signs of problems. The treatment nurse noticed the rash during a routine dressing change but never thought to inquire about any now dietary or medication changes. It was not until the time of discharge when the patient read the drug information sheet advising that any skin changes be reported that the patient asked the discharge planning nurse if the week-old rash was significant.

What could have been done differently?

Was anyone at fault? Who?

Why is good communication especially important in a situation in which there is a functional division of labor?

What types of problems could you expect if staff members focused on their own tasks and failed to communicate with each other about the patient’s emotional, psychosocial, educational, and discharge needs?

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