1.) Mr. Ames is a 67-year-old man who recently had his right leg amputated just below the knee following a serious infection. Mr. Ames suffers from a number of comorbidities that make his treatment extremely complex. During his time in the hospital Mr. Ames did not follow medical advice and opted into an amputation that was much lower on his leg than the medical team advice. After a 10-day recovery in the hospital, Mr. Ames was transferred to a rehabilitation center for further health improvement. His ultimate treatment goal is to be able to stay at home while his wife continues to work nights, and to be able to perform necessary ADLs. He hopes to not add any additional burdens to his wife’s life. The treatment team at the rehabilitation …show more content…
Ames made great improvements in his condition and discharge planning between the interdisciplinary team began to occur. The occupational therapist citied improvements in his ability to perform ADLs but emphasized the need to further develop these skills. The OT also referenced a concern for Mr. Ames memory capability. Once home Mr. Ames hopes to begin driving again, but with his visual impairments and physical condition this will require further evaluation. The physical therapist hopes that gait training will continue at home. Both the PT and OTs goal of improving Mr. Ames physical condition will allow Mr. Ames to be able to live at home. Between visits with a psychologist and social service worker Mr. Ames has discussed his fears of returning home. He hopes to do so in 2 weeks, six weeks following the amputation, but recognizes that this may place extreme burdens on to his wife. Mr. Ames hopes that having everything set up for when he returns home, all therapeutic services preplanned, will ease the transition. The social worker is working with both him and his wife to do this. Many other members of the team have visited with the Ames family to help further ease this transition. Respiratory therapy has suggested the use of a CPAP machine for better sleep. Podiatry has trimmed Mr. Ames toenails. Prosthetics and orthotics have fitted Mr. Ames with a prosthetic and diabetic pressure relief shoe. The shoe is working well, but
T. Paulette Sutton is one of the world’s leading experts in bloodstains and is the former Assistant Director of Forensic Services and Director of Investigations at the University of Tennessee, Memphis. She has been involved in nationally known murder cases and has worked hard during her long career to make a position contribution to the legal system. Sutton says, “Its best for my fellow man that we get the killers off the street.” Since 2006 Sutton has been officially retired but continues to teach, consult, and testify about her area of expertise.
The relationship between a father and a son can be expressed as perhaps the most critical relationship that a man endures in his lifetime. This is the relationship that influences a man and all other relationships that he constructs throughout his being. Marilynne Robinson’s Gilead explores the difficulty in making this connection across generations. Four men named John Ames are investigated in this story: three generations in one family and a namesake from a closely connected family. Most of these father-son relationships are distraught, filled with tension, misunderstanding, anger, and occasionally hostility. There often seems an impassable gulf between the men and, as seen throughout the pages of Gilead, it can be so intense that it creates
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
Andrews is a sensor manufacturer in the market. While the company has been unable to develop a straightforward competitive advantage over the course of the past three years, the competitive landscape of the market has become a significant source of concern for the company’s leadership. There are other companies out there who produce better products, or are able to compete strictly based on price cuts. It came to the CEO’s attention that there is an opportunity for Andrews to shift a large portion of its production to an offshore location. This decision will not only allow Andrews to reduce its labour and material costs, but will also allow for improved distribution practices.
She also had a navicular fracture in her left foot. This injury required grafting of the bone from her knee onto her foot. The process required two surgeries because doctors had to go back in and remove hardware from her foot and leg. The end result caused significant scarring to Barbara’s foot and leg. She was also placed in a cast multiple times and had to use a walker during her rehabilitation. As one might image, her daily activities were greatly altered. She claims she is unable to complete many of the tasks that she was able to handle before, which has led to great hardship. Her medical bills alone were estimated in excess of $54,000 for the
There are six set standards of the nursing practice; assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ANA, 2010; pp. 9-10). Throughout a typical shift on the unit I work for, I have set tasks I am expected to complete in order to progress the patient’s care, and to keep the patient safe. I begin my shift by completing my initial assessment on my patient. During this time, I am getting to know my patient and assessing if there are any new issues that need my immediate intervention. From here, I am able to discuss appropriate goals for the day with my patient. This may come in the form of increasing mobility by walking around the unit, decreasing pain, or simply taking a bath. Next, I plan when and how these tasks will be able to be done, and coordinate care with the appropriate members of the team; such as, nursing assistants and physical therapists. Evaluating the patient after any intervention assists in discovering what works and what does not for the individual. “The nursing process in practice is not linear as often conceptualized, with a feedback loop from evaluation to assessment. Rather, it relies heavily on the bi-directional feedback loop...
March 30, 1981 was a peaceful day. President Ronald Reagan was walking outside enjoying the fresh air when suddenly shots were fired. Six shots were fired in total, but only one shot hit Reagan due to a bullet that ricocheted. Luckily, Reagan was hit in the abdomen; therefore, he survived. The “mastermind” behind the attempted assassination was a man named John Hinckley. Hinckley believed by going through with this assassination it would be a romantic scenario for himself to confess his undying love for the actress Jodie Foster. Before long it was time for the Hinckley trial and after hearing his side of the story, the jury came to the conclusion that he was crazy. Hinckley was later found not guilty by reason of insanity and admitted to
...newicht and Dunford (2004), physiotherapists, occupational therapists, Doctors, nurses, specialist pain teams and dieticians all care for the patient at once.
techniques, and promoting rehabilitation as an aid to full recovery. This is what Dr. Lyle J.
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
The ICF model can be used to identified the patient’s impairments, activity limitations, and the participation restrictions. For this patient, his impairments are the inability to achieve full left knee extension and flexion, decrease strength of the lower extremities, decreased kinesthesia of the upper and lower extremities, decreased motor control of the trunk. The activity limitations of the patient are decreased sitting balance, decreased ability to perform sit to stands, poor standing balance, and inability to ambulate independently. The participation restrictions of the patient are the inability to spend quality time with children in the town and the inability to navigate home and community independently. When evaluating this patient,
Therefore, she may find it harder than most of the population to transition into the role of the patient and rely on others to make clinical judgements to promote and protect her recovery. Moreover, she was in a lot of physical pain, with her right leg in a full cast, causing her to be at bed rest. This I believe, as well as the patient being more aware of the inner workings of the hospital compared to other patients without a medical background, may of contributed to her ill ease and need to feel in control of her nursing care, over that of her care plan set by the
Before I was born, my grandfather was involved in numerous surgeries on his left knee to fix torn ligaments as a result of his line of work. As time went on, the physical effort took a toll on his good knee, prompting additional surgeries. At the time, doctors suggested a bone or joint fusion surgery to help with the type of injury he sustained. It was a permanent procedure ultimately resulting in the inability to bend at the joint and making his left leg two inches shorter than his right. Everyday tasks that I had taken for granted, such as driving a car, using the restroom, and even standing for long periods of time became impediments to daily living. Having heard about this traumatic and chronic experience, it remained in the back of my mind for some time. It was not until I was 13 years old when I had my first encounter with an occupational therapist during an appointment that I
“Mitchell! It’s time!” my mom shouted from down the stairs. Nearly in tears at this point, I slowly walked down the stairs, stalling time with every step I took. Dreading this walk toward the kitchen table, I absolutely would rather be anywhere in the world than sitting at the kitchen table doing this. I took my time pulling the chair out and taking a seat. The pad was already on the table along with all of the necessary equipment. I tried telling my mom I didn’t need this, but the pain in my leg knew that was a lie. I knew that in only a few minutes all of this worry would be behind me, but the sight of the syringe and tourniquet were making me sick to my stomach. All of my focus was on the needle as it rested in my mother’s hand.
Physiotherapy is the study of the movement and function of the human anatomy and the relationship between the persons’ health and wellbeing (Dhrs.uct.ac.za, 2015). A physiotherapist’s speciality is treating “individuals across the life-span who have illness, injury or disability affecting the neuro-musculoskeletal, cardiopulmonary, vascular, and neurological systems” (Ontario Physiotherapy Association, 2015:3). A physiotherapist’s main goal is for their patient to receive the highest level of independence by educating patients how to “prevent reoccurring injuries” that disrupt their daily routine (Ontario Physiotherapy Association, 2015:3). Physiotherapists would deal with “long term ailments” (Zweigenthal et al., 2009:235) that cannot simply be treated with the dosage of medication but with the dedication from both the physiotherapist and patient in the appointed interactive physical sessions, a treatment plan can be formulated to guarantee the most efficient road to