The patient arrived on time for her counseling session. Reported doing okay with her dose, but wishes she can have an increase as she still experiencing some cravings, but is trying not to relapse. The patient vented about her transportation issues with Logisticare and her ex-husband. Patient says, " I need my rides to be reinstated because I can't keeping back and forth with him.......Did you get my discharge summary?.... Please send it to Logisticare." This writer showed the patient about a recent fax from Hartford Dispensary, referring to her discharge summary and a statement on the clinic's letterhead stating the date of the patient discharge and when she was medically taper off on her dose. According to the patient, she does not want her previous counselor statement to be sent to Logisticare, …show more content…
Furthermore, the patient appeared to admit about taking a prescribed medication from a friend, but when questioned further, she recanted her statement as the patient was not cleared if it was recent or in the past. However, this writer informed the patient as a warning of the clinic's policy. This writer reviewed the patient's RX scripts has they all expired today; however, the patient plans to pick up her script this weekend and provide to CSAC Nursing on Monday or Tuesday. Again, this writer discussed with the patient about he importance of validating her scripts on time. Please note, the patient arrived to the clinic limping and complained of back pain. Denies the need to be medically assessed at CSAC as she plans to go to the ER later today after her Cardiologist appointment to be assessed. She was advised that any discharge summary must be provided to CSAC. Patient then reports, she's been taking motion. Other: This writer attempted to call Logisticare, but the line was disconnected by Logisticare
3. The patient had informed this writer initially of his goals of wanting to return back to the Hartford Dispensary due to the length of time he has been with the clinic and his positive rapport with his prior counselor at the other facility. The patient was compliant with his individual sessions with this writer and provided cancellation if unable to attend the session in the meantime while he awaits on the process of completion with his intake at Hartford Dispensary.
D-This writer met with the patient as he was placed on HOLD to address the status of the IOP. The patient provided this writer a paper that was provided to him with listing of IOP for him to explore. The paper shows scribbles of the patient taking down notes about his attempts of who he called. The patient reports Connecticut Addiction Recovery will call him back within 24-48 hours. The patient was able to schedule an appointment with New Direction for May 20th at 7pm; patient spoke with Dan. This writer commends the patient for all of his efforts; however, the patient needs to schedule something earlier than May 20th. This writer asked the patient about ICRC-Coventry House. According to the patient, he called the contact number and showed proof. The patient reports that ICRC gave him two different number and told him to do a walk-in at 8:30am. This writer shared with the patient about a recent conversation this writer had with ICRC. This writer told the patient
D-The patient arrived on time for her session. Reports stable on her dose. This writer discussed about tapering off on her methadone, at which the patient is willing to consider doing, but needs more time. She then says, " I might consider doing it next month, but not right now......I was doing it before, but it stopped....just want to take my time." The patient then discussed about having to go to SSA to obtain the payment for the funeral cost. The patient is upset about the small amount she is about to receive. This writer discussed the grieving process of her loss of her husband and also, her mother in law. The patient appeared to be annoyed with her son for not participating in his grandmother funeral arrangement and also, not showing
D-Met with the patient to address a fax from DCF request of the patient records. The patient immediately said, " Don't send this shit. I cannot stand that worker.....I was in court the other day and I am tired of this and this worker always in my business." The writer explained to the patient that should he continue to refuse to sign an ROI, it may hurt his reunification with his son as the patient detailed to this writer about how DCF got involved in his life ( According to the patient, he was intoxicated when visiting his son and a case was called against him and the child's mother). The patient made it clear to the writer that he has no desires to signed an ROI for DCF and for the clinic to ignore DCF request.
This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,
D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this
D-Spoke with the patient as she was being curbside dose. This writer reiterate about TEAM recommendation, at which the patient declines the notion of being placed in a skilled nursing facility due to her medical issues.This writer informed the patient that her level of care is inappropriate for this treatment and a high level of care would be more efficient. According to the patient, she's working with Chrysalis and is willing to sign an ROI for this writer to communicate with her case worker Anthony, aka Tony. Reported stable on her dose.
The patient arrived on for his counseling session. Reports stability on his current dose and denies the need for a dose increase or decrease when offered by the writer. The patient was made aware that he will be reassigned to counselor, Scott effectively immediately as his new assigned counselor will schedule his next session. The patient reports of no update with his medical pertaining to a referral to another PCP as he is currently still seeing the same medical provider.
Pt. called this writer to report that he no longer wanted to be in the program. Pt. asked if he needs to sign a Voluntary Request for Termination. Pt. reported that he is going to stop by the clinic to pay his tx services fees. Pt. stated, "I am done wit methadone. I'll go there tomorrow and pay my bill in full." Counselor told that he needs to talk to the head nurse and to sign the AMA Detoxification Agreement tomorrow, Saturday 2/25/17. After discussing this issue with him, he still insisted that he did not want to be in the program and he wants to sign the AMA Detoxification Agreement
The patient self-admits that she was not always compliant with her appointments due to changes to her work schedule since the month of December of 2016, but shared this information with her counselor. The patient is requesting to be reassigned to another counselor as she reports of not having a positive rapport with Cherron. Cherron was advised based on the patient complaint that it will be addressed with the Clinical Director based on her request to be
D-Met with the patient as she placed on HOLD due to recent concern of her overall well-being reported by Nurse Frank as he reported to this writer yesterday of his concerns that the patient's boyfriend is refusing her to increase on her methadone due to an agreement and the patient tends to appear emotional. Upon meeting with the patient, the patient immediately knew why she is meeting with her and started to get emotional. Denies feeling SI/HI. According to the patient, she had an agreement with her boyfriend of which she agreed to increase her dose up to 55mgs as her boyfriend will closely monitor her recovery. The patient does not feel unsafe around her boyfriend as she reported. This writer strongly advised the patient that she has rights to her own recovery process because it's her in the recovery and seeking treatment, at which the patient agreed. But says, "I am fine with my current
The writer inquired from the patient about what will work for him for the sake of the patient to take his recovery serious. According to the patient, he did not have a logic answer, besides the clinical intervention that was already implemented. The patient reported that he haven't used for nearly a month; however, his recent UA dated on 9/25/2017 was positive for opiates and cocaine. The patient deny relapsing, but the writer shared with the patient with regard to his past UA results as to how this result is incorrect. No response from the patient besides, " I am
This is the case of benevolent deception as the information regarding the patient health conditions was not revealed. The healthcare professionals withheld the important health information to protect patient from harm i.e. stress and depression. In addition, they thought that it is not an act of lying and morally permissible as it was benefitting the patient. Fry et al. (2011) mentioned that the Hippocratic Oath and the Florence Nightingale Pledge tell us to do what will benefit the patient and protect
Patient is a 35 year old male presenting to the ED involuntarily as petitioned by his cousin due to threatening to shoot himself with a gun. At the time of assessment, patient denies feeling suicidal or having a plan. When confronted about admitting being suicidal and having a plan to nursing staff and TACT, Mr. Crowson stated "He is here because he is going through withdrawals and his mother is lying." The Mr. Crowson reports in the past year he has lost his father. Mr. Crowson reported wanting to receive Methadone from hospital to help with withdrawal symptoms. He expressed feeling body aches, stomach cramps, chills, irritability, angry, and verbally aggressive behavior. Patient refuses to finish full assessment.
Counselor flagged Pt. on the AMS computer system to meet with this writer before dosing. Pt. met with counselor discussed and completed an AMS Dose evaluation to increase her dosage of methadone because she isn’t feeling well and experiencing side effects. Counselor prompted Pt. to talk about her pregnancy, medical appointment and to schedule her monthly therapy session with this writer. Pt. reported that her pregnancy is going well and she is having a lot of appointments at the Bay health hospital in Dover, DE. Pt. stated that they can’t determine the baby sex because her baby has the legs cross. Counselor told pt. that the Bay Health Hospital has a good nicu care unit and professional doctors. Counselor asked Pt.is