Caitlyn Smart is a 2^nd year nursing student on a 4- week Professional Experience Placement. She has been placed in a large metropolitan public hospital on a medical ward specialising in patients with respiratory conditions. On the 3^rd. week, she has adapted to the ward well feeling comfortable as well as confident being there. It is now Wednesday, and she has just entered the ward on an early shift. As always, she arrives about 10 minutes early.

During handover Caitlyn is allocated 4 patients and she will be supervised by Registered Nurse Kylie Scott. She is told by the Team Leader Adam Vronsky that

“Kylie won’t be here until 9am but I am sure you will be OK, just come and get me if you have any problems.”

Caitlyn proceeds to go to and greet her 4 patients who are:

• Mrs Maria Giannopoulos – an 87yo Greek woman who does not speak very much English and her daughter in law is present with her. She has come in with an exacerbation of her COAD
• Mr James Smith – a 54yo businessman who has pneumonia
• Ms Helen March – 65yo woman with pneumonia and asthma, who has just arrived from ICU after being treated for respiratory failure.
• Mrs Vera Yardley – a 77yo woman with emphysema and who is non-compliant with her medication regime and smoking.

When she approached Mrs Giannopoulos, her daughter-in-law tells her that her mother-in-law has pain and she needs something for it. She checks her medication orders and find there is no pain relief ordered for her. She then approached Adam who says

“Just give her 2 Panadol and I’ll fix it up later with the Dr.”

She proceeded to dispense 2 Panadol and take it to Adam to check who says

“Just go and give it to her will you, for goodness sake, you don’t have to get every little thing checked!”

She goes to administer the Paracetamol to Mrs Giannopoulos who looks at her blankly and says, “No No!”.