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You are in your final clinical rotations of nursing school. The clinical instructor assigns each student to two

patients. Although you accept your assignment, you feel uneasy about providing care for two patients, especially since both have congestive heart failure. You are extremely cautious as you check the prescribed medications in your reference book, check each patient's name band, check the medications with the staff nurse, and administer the doses. To save time, you take both patients' medications into the room at the same time. You document every nursing action, including the education on medications given to patients. When the instructor asks how things are going, you feel confident in stating that you are handling two patients very well. You further explain how you took the initiative to educate one of your patients on the side effects of a new blood pressure pill when the patient stated he never took the medication before. The instructor asks to see the order for the drug, but when you look for the physician's order, you are unable to find it! You suddenly realize that you switched the patients' medications and wrongly dosed both patients. Later in the shift, one patient's blood pressure drops to the point of requiring a transfer to ICU and the other goes into renal failure, requiring dialysis.

Who is liable for the actions of the student nurse—you (because you gave the medications), the staff nurse (who checked the medications), or the instructor (who was supervising)?

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