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Chapter 4 interacting with patients
Chapter 4 interacting with patients
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Met with the patient upon request as the patient approached this writer in the lobby area. This writer agreed to meet with the patient to address his concerns. According to the patient, he was in a MVA on 4/27/2017 on the highway leaving Vernon, CT. The patient was unable to dose on the weekend due to failure to report the MVA and not having the hospitalization report from Hartford Hospital (discharge summary). This writer explained to the patient about the clinics protocol as this was discuss during his Orientation II with this writer as this writer remember mentioning it during the group session about any visits to the ER and/or any hospitalization, patient are responsible for producing the discharge summary to medical.
The patient reported that he went to the Hartford Hospital and signed an ROI for the hospital record department to fax it to HCRC. The patient have shown this writer proof of the ROI of which he signed. This writer had the patient signed an HCRC ROI and contacted the Hartford Hospital medical record department and was advised from Oscar, he faxed the ER summary two minutes ago. This writer checked the fax, while the patient
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This writer relayed the message to the counselor afterwards and also update TEAM about this writer encounter with the patient. The patient met with his counselor for further assessment to address the benzo issue and the hospitalization report. It is noted in the hospitalization report that the patient was positive for heroin and benzo. His girlfriend or wife reported to the hospital staff that the patient was using illicitly on the day of accident-20 bags of heroin. Furthermore, the hospital report also noted that the patient was aggressive towards staff members as he tried to leave the hospital and being cooperative during the medical
Bourgeois notified of the decision to detain client for Grave Disability and was in agreement with client being placed for further psychiatric care. Dr. Bourgeois requested the name and contact information for help in facilitating client being transferred to an LPS designated facility, due to being unable to place him on multiple occasions. This writer contacted Supervisor Robin Boscarelli regarding this issue. It was decided that a member of the Treatment Team will be reaching out to the Hospital Unit Clerk, Gina later this morning. Dr. Bourgeois was in agreement with this plan. Client's Clinic to be notified via email of this Crisis
Registered Nurse Pausits, a defendant out of the many involved with Parson’s case, has failed to provide Randy Parson with the correct prescription drug during his stay at Standish. The Plaintiff wanted to prove that she unsuccessfully administered medication to Randy Parsons and that a reasonable jury can conclude the fact Pausits was aware of the risks to Parsons. The court has reversed the grant of summary judgment to Nurse Pausits, because this case would rise to the level of deliberate indifference. Plaintiff Parsons revealed that Pausits perceived facts to infer substantial risk to Randy Parsons and drew the inference. She had to state she was aware, which she did, of a substantial risk. Evidence has shown that Nurse Pausits could have gotten Dilantian for Randy Parson if she viewed the situation as an emergency. Pausit’s case has discovered confirmation that she administered 100mg of Dilantin to Randy Parsons August 27, at 6:00 p.m. However, in Randy’s toxicology report, no Dilantin was shown in his body for 3 days before his death, which was August 28. Wellbutrin was shown in Randy’s body instead of Dilantin, which is a form of an anti-depressant that helps people suffering from seizures and can prevent causing a seizure. Displayed that Pausits signed Randy’s Medication Administration Record (MAR), when the prison log showed that Registered Nurse Alexander performed the medication August 27, raises a red flag as to who performed the medication and what prescription was given. The Plaintiff provided enough evidence towards Pausits in that she has unsuccessfully administered the medication to Randy and that Pausits was aware of a substantial risk to Randy Parsons. Because of this, a jury can place more significance on the t...
The patient is a 45 year old male who was in a car accident that
The methadone program at Rosthern Hospital is a very active and intense program. Boast over 20 patients that are regular methadone users, the involvement of the physicians, pharmacists, nurses, and addiction counselors are key (Melle, 2016). Dr. Melle is the coordinator of the methadone program at Rosthern Hospital. His roles include, patient recruitment, patient care management, follow up care, and most importantly prescription and dosage of the methadone (Melle, 2016). Pharmacist’s role in methadone treatment is providing the methadone to the hospital, as well as in Warman pharmacy they monitor and dispense some methadone to some of the patients in the methadone program. Addiction counselors are an outside resource that the staff at Rosthern hospital can utilize. There are not social workers or counselors at Rosthern, but Dr. Melle and the nurses prefer if their patients are regularly seeing an addiction counselor while in the methadone program. Finally, the nurses role in the methadone program is early treatment and monitoring of patients during detox, the continued monitoring or patients when methadone doses change, dispensing methadone and monitoring our patients in the recovery program, and observation of patient’s success during the program. Together the interprofessional team has successfully treated dozens of patients, and the methadone program address the needs of both the patients and the addiction issues that are plaguing the surrounding communities (Melle,
This writer explained to the Yommala that the patient returned to the clinic with no paper works and it appears to confusion as to whether or not this patient was scheduled to do a medical procedure or seeking inpatient treatment. According to Yommala, she has been updating ROUNDS about this patient and the patient medical procedure was scheduled in advance in the hopes that the patient would be negative from all illicit drugs to
Client text CM to ask about the new patient registration since he moved to Somerville. Client asked if he can call the CM, CM called the client and it turned that he quite from his job in the little coffee shop because he has to work very early and that not helping him to focus in his homework CM mentioned that he stills has a job in Mays’ and he can increase his hours there so he will be able to cover all his expenses. CM will send to him the information of the hospital so he can call them to register there.
Karissa works for her drugs, however she has been always supported indirectly or directly by her family. For instance, the mother gives her monety every week in advance, the aunt usually is taking care of her addiction to tobacco. The father and stepfather gives Karissa money for anything that she may need. This issue create a new dilemma about Karissa been a functional addict. In other words the family is helping her to support her addiction. At this point, Karissa was addicted to heroin. At the same time, Karissa was buying benzodiazepines and she mixed them with heroin to reach a bigger and longer high. As per the National Institute of health “Mixing Benzodiazepines with heroin can cause respiratory failure”. Further, Karissa uses Suboxone which is an opioid medication used to treat narcotic addiction. Heroin is an expensive addiction or at least the the type of heroin that Karissa was using is expensive. Karissa was spending close to $1400 a week in heroin. It was not clear how she exactly got the money to satisfy her addiction, but she was able to handle it. For instance, Karissa got her prescription from her Doctor for Suboxone. However, Karissa almost immediately sells the Suboxone for $480 which is good for 10 bags of heroin. During the interview, Karissa stated that she needs a least 30 to 32 bags of heroin and at least 20 mg of benzodiazepines to get the ultimate high. After Karissa shoots all those bags she can barely walk or breath. She can barely verbalize what she is speaking. As mention before Karissa lives with her brother and he is the only one who is able to help her if she overdose to the point that the brother has a Narcan kit pack which is a medication used to reverse the effect of opioids during an overdose episode. At the time that Karissa has to get to work she needs to shoot 10 bags to function normally. There was any history of drug or alcohol abuse in the family. There was any psychiatric,
A professional nursing practice is predicated on many tenets, which ensure optimal functionality and growth. A successful organization requires the systematic employment of ethical values, as well as structural, organizational and relational leadership. In essence, a nursing practice must fortify its corporate structure, productivity, operational flow, and professional relationships in order to thrive. The purpose of an organizational meeting is to address the foundational elements of a successful practice. Along with delineating guidelines, a meeting should reinforce structure, a unified sense of purpose, and address lingering issues.
In order for hospitals and other health care facilities to prevent the thousands of deaths and injuries that occur every year due to medical errors; health care systems were required to implement new record keeping technology. This technology has made patient information and treatment accessible to all who needed to see it. This is especially important when a patient has more than one attending physician and their care relies on each doctor knowing what the other one has done, serving as the prime communication tool between doctors. If organizations do not centralize their technology and essentially their patient databases, the potential for duplicate work or inefficient patient care can exponentially increase. These high tech medical records can help protect physicians and hospitals alike against any lawsuits that may be filed on behalf of their patients. By correctly and thoroughly documenting all symptoms, illnesses, treatments, medication dosages, and diagnosis’ the doctor and health care providers can effectively prove what actions were taken with the patient, communicate with third party billers, and even use the gathered information for teaching purposes. Keeping a precise record of a patient’s medical treatment makes a large difference in many aspects of health care; especially when a negligence tort or claim is filed against the hospital and/or a doctor.
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
I had the opportunity to meet with Dee Laguerra for a few hours and learned so much about the Medical records side of our facility and its impact on healthcare organization. As Director of Health Information Management (HIM) she is responsible for many aspects of managing the medical record; which is a legal document. I did not realize how complex this department is and how vital this department is to the legal and financial position of the organization. Dee’s position as director is the responsibility for the collection, organizing, scanning, and completions of the medical records in a timely matter after the patient is discharged. The reason for the timeliness of scanning the medical records is for the preparation for the coders to review all the charts to code for insurance billing. The time requirement for th...
Christopher death could have been avoided if the Doctor had been able to identify the cause of his desaturation on time. Due to lack of nursing care and many human errors from both the medical team and nurses, it leads to his death as per the inquest. Patient safety was compromised. It was found that Dr. Wooller the anesthetist and Dr. Young the surgeon who operated on Mr. Hammett didn’t investigate on the significant oxygen desaturation event that occurred in PACU while he was transferred from Operation Theater. DR. young assumed it was due to obstructed airway. As Mr. Hammett had Guedels inserted. The inquest stated that the anesthetist was supposed to review the arterial blood gas and transferred Mr. Hammett to High dependency unit due to his desaturation event for more than 20min. The nurses looking after MR. Hammett in PACU was RN Turrell and RN Proud. RN Proud notified Dr. Woller about the desaturation event for which doctor paid the visit but didn’t physically examine Mr. Hammett and left with short conversation. If Dr. Woller had investigated the cause of desaturation event at that time probably they could have prevented the rest desaturation event but unfortunately, none of them were implemented, which lead to additional complication Following the event the deceased was administered bolus morphine for his pain, which was scored 4/10. The nurses working in PACU RN Proud notified the anesthetist about the oxygen stat
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.
Manuel is a client that has been depressed for the past two months. He has lost his construction job, because he missed too much from the effects of drinking heavily and using drugs. His use of drugs and alcohol became a daily routine and was close to killing himself several times. He would be in his apartment all day watching T.V. and drinking and isolated from his family. Also thought of death a lot. His girlfriend left him and became even more depressed because he was alone. He used more to feel better but it made him feel more depressed. He did go see a doctor and prescribed him medication for his depression but he didn’t disclose that he was using drugs.