I am writing this letter in recognition of Alice Capace, LMSW.
I am a busy primary care physician, and several months ago had a challenging patient struggling with alcohol addiction and abuse. Such addictions manifested in the repeated use of the emergency room and hospital. I struggled with coordinating his care across primary care, addiction behavior health, emergency room and hospital services, and as such referred him to the Health Home team.
My patient was assigned to Ms. Capace under the management of Roberta Costanzo RN NP. Since becoming involved in my patient’s care, Alicia has gone above and beyond to communicate with the patient, myself and my office, the patient’s insurance company, the ER and hospital staff, outpatient treatment
The medical secretary, registered nurses, licensed practical nurses, and physicians communicated consistently and appropriately so that all staff could effectively complete the actions required of their respective roles. I noted the strong relationship between the nurses and the physicians. The nurses held a heavy influence on the physician’s decisions regarding a situation, because the nurses were the ones conveying pertinent information related to the patient’s status. Based on the information provided, the physician would make recommendations and provide guidance to the nurses. The physician’s directions were then carried out by the nurse, influencing the nurse’s plan of care for his/her
Substance abuse in the medical field is a growing issue, and nurses are no exception to the stigma. The American Nurses Association (ANA) reports an estimated six to eight percent of nurses has a substance abuse issue that has directly impaired their practice (Alunni-Kinkle, 2015). This means that as many as one in every ten nurses is practicing with an unidentified or untreated substance abuse issue (Alunni-Kinkle, 2015). This paper will briefly discuss the many factors that contribute to substance abuse among nurses, as well as reporting and consequences associated with
Over the years, substance abuse in the United States has become a persistent issue affecting many individuals. In 2008, it was estimated that 17.8 million Americans over the age of 18 where substance dependent (Epstein, Burns, & Conlon, 2010). Many of these individuals being affected are nurses. Ponech (2000) stated that "approximately 10% of the nursing population has alcohol or drug abuse problems, and 6% has problems serious enough to interfere with their ability to practice" (as cited in Talbert, 2009, p.17). Studies show that nurses have a 50% higher rate of substance abuse compared to the rest of the public (Epstein et al., 2010). Among the many factors that contribute to the nurse’s issue of substance abuse, accessibility to drugs in the work environment has played a significant role. Substance abuse among nurses is an arising issue in need of attention, it is alarming to know that patient safety and care is in danger when a chemically impaired nurse is in the workplace.
This clinical week started out very interesting as I had a patient who had a cardiac catheterization procedure schedules. I had the opportunity to gain insight on pre-procedure nursing tasks and interventions as well as post –procedure. The patient had been admitted due to chest pain and an Echo test conducted showed aortic vulvar insufficiency. This led to the need of cardiac catheterization a procedure performed to visualize heart structure and blood vessels under a fluoroscopy to further asses this condition. Before the procedure the nurse called the interpreter on the IPad to interpret the patient teaching regarding the procedure including asking about allergies to iodine or seafood and encouraged questions from the patient. The nurse then
Monroe, T., Pearson, F., & Kenaga, H. (2008). Procedures for handling cases of substance abuse among nurses: a comparison of disciplinary and alternative programs. Journal Of Addictions Nursing, 19(3), 156-161.
Poulos provided support to one of her patients during a stressful time when diagnosed with prostate cancer. She was diligent during his six week course of radiation treatment. The patient was monitored closely for any untoward symptoms that could interfere with his dialysis treatments. The fluid gains and/or losses between treatments interrupted his normal bowel function. She worked with the physicians to achieve a positive outcome for the patient. Ms. Poulos had another patient she worked closely with who had a few hospitalizations in this past year for ischemic colitis. Being a fragile older man the surgery team felt he needed to be treated conservatively. Taking care of this patient was challenging because it was difficult to keep his blood pressure elevated to prevent further ischemic issues however her diligence in caring for the patient lead to his success.
care for patients and I felt she disregarded it. Dr. Abbasac was very controlling over the whole
This paper discusses alcoholism, its behavior on individuals and its association with relevant health conditions. With the changing health care system, health care providers, nurses, and counselors have stepped into the arena of health promotion. A scenario case study was put together to depict the need for counseling individuals with risky behaviors and how it impacts their health. Recommendations and goals were incorporated into the clients counseling. Millers interviewing technique was used to guide the counseling session conducted with a person afflicted with alcoholism with the end resulting in behavior changes. Motivational interviewing is an approach based upon principles of experimental and social psychology, attribution, cognitive dissonance, and empathy placing emphasis on internal acceptance for change. Cognitive dissonance is created by contrasting the ongoing problem behavior with the behaviors negative effects. Empathy is incorporated to channel the conflict into a behavior change solution.
On September 28th, 2016, I was assigned to a patient on the rehab floor. I looked up this residents information before hand in his chart. There I was about to see his past medical history which concluded: Cancer, MS, Hypertension, and a right upper lobectomy. I assisted with this
Sam was only assigned one patient, D.H., a 41-year-old male admitted on 11/7/16 for end-stage renal failure. The patient’s code status was not determined and there were no discharge plans. D.H. was an admission, therefore Sam was able to experience the admission process and how a patient might adjust to their first few hours in the hospital. She reported that he seemed to be slightly anxious and afraid of the whole process. Sam was administering medications on Tuesday and was able to push an IV med for the first time. Additionally, the patient was a dialysis patient, so she was able to accompany him to his peritoneal dialysis treatment that
After the handover, I was asked by my mentor to attend to a patient who is bed ridden to have her personal care done with the assistance of one of the health care assistant staff. The patient was recently admitted to the ward and she looks sc...
With limited resources, I saw dedicated medical professionals going the extra mile to ensure success. This reminded me that our greatest resources lie in the dedication and commitment of each team member. Whether we were treating pneumonia, working up a potential MI, managing cancer treatment or alleviating the symptoms of diarrhea, attention to detail was always important. Having built a great rapport with my team, I was afforded numerous opportunities to hone my clinical skills and to play critical roles in the management of patients under the supervision of my Brooklyn Hospital Center Clinical Preceptor, Dr Edwin
Mona Counts is a Nurse Practitioner at her own primary care facility. Her clinic provides health care to over five thousand patients who live in the heart of Appalachia. Bob Wilkinson is a Pediatric Oncology Nurse. Bob takes care of very sick children and their families. Ardis Bush started as a Staff Nurse over 25 years ago and worked her way up to being Nurse Manager. These nurses establish a rapport with their patients and their patients’ families by talking to them like normal human beings, and not just as patients. These nurses relate and listen to their patients, which makes them feel comfortable. Both Mona and Ardis even make house visits to check up on patients and to see how they are doing.
I was assigned to patient B.P. She was admitted on September 6th from RMC. Her admitting diagnoses are acute embolism and thrombosis of unspecified deep veins of lower extremities; Unspecified Dementia without behavioral disturbance; Major Depressive Disorder, Single episode; Intervertebral Disc Degeneration, Lumbar region; Essential hypertension; Vitamin Deficiency, Dorsalgia, and pain. She had two patches covering wounds on forearms bilaterally. There was an order in her chart for occupational therapy and physical therapy, but interacting with her throughout the day, I wonder how often she accomplishes it. They also have behavioral monitoring and side effect evaluation of the psychotropic medications she is taking. B.P seemed very confused through the whole day. In the morning I went in and introduced myself and asked her some questions to evaluate her mental status and she immediately brought up her headache. I asked her if she knew where she was and she was unable to answer that along with what the date was. Clarissa then helped me change her depends and she was able to