Case Management Observation

On Tuesday 06/27/2017, veteran Mr. Saenz walked very angrily in my office with his wife about 11:00 AM. I greeted them and offered to sit down; Mr. Saenz and Mrs. Saenz were very upset and asked me where they need to go as they have VA examination, they both said “nobody tells them anything; they have been sitting in waiting room”. They told me that the lady on the desk told them to come to me.

CM was out for the period of 1/9/2017 to 1/6/2017. On 1/20/2016, CM met with the client to complete Bi-Weekly ILP Review. Client was dressed in proper attire for the weather. In the meeting client appears to be exhausted, weary and tire. CM inquire the reason client appear to be tired. Client replies” she is not feeling well, her diabetic and high glucose blood pressure is either low or high. CM inquires if the client met with the onsite medical staff. Client replies “no’. She has an appointment with the PCP.

CM met with Thomas, Kevin/ Open Arms Case Manager and Amy/ ESP Staff to conduct Thomas's discharge, case management services and ID Waiver Intake. Thomas appeared tired as his eyes closed and head lowered for some of the Intake. He complained early during the meeting that he didn't want to answer a lot of questions, however with some verbal encouragement he went on with his responses. Thomas talked much about his medication and seemed at times to get his current medications confused with his old medications. Due to a history of overdosing and taking medications that weren't prescribed to him; his roommate makes sure Thomas is taking the correct medications. He has been living at current address for 2 months and Kevin feels the houses is in

CM was on vacation for the period of 11/25/2016 to 12/12/2016. On 12/17/2016, CM met with the client to complete Bi-weekly ILP Review and to obtain information concerning TPS (“Temporary Protective Status”). Client was dressed appropriately for the weather. She was well-mannered and groomed. In the meeting client appears to be cooperative, friendly and forthcoming with information. Client speech was spontaneous and soft. During the meeting client become emotionally teary when CM inquiries about client TPS status. Client provided CM with a brief history how she came into the shelter system. Client continues to report her most important means of support passed away recently, which is part of the reason she came into shelter. Client continues to denied suicidal or homicidal ideation.

G- CM met with client for a weekly case management, and to continue assisting with his housing goals.

I: CM questioned client about his health and skin condition.CM asked client if he was currently receiving mental health service at the VA outpatient clinic on. CM discussed housing programs with client (skid row housing, VASH). CM also inquired about client’s motivation level, by using open-ended questions. CM questioned whether the client was interested in participating in the program savings plan. CM continued to assess for PTSD symptoms, substance abuse, and medication compliance.

I: CM used open ended questions to inquire about the client’s missed appointments with LAMP VASH. CM questioned client regarding updates with his social security payment. CM discussed a plan with the client that will help the client prioritized all of his housing appointments. CM explained to the client the importance of keeping all of his housing options available by attending all of his appointments and meeting all of the requirements.

Lights of Zion will hire an experienced case manager/“reentry counselor,” to assist reentry experience from prison to sustained employment. The case management begins with a comprehensive individual assessment. From this assessment, a service plan is created that manages every aspect of the participant’s reentry program. The case manager monitors the plan, ensuring that all goals and objectives are being reached. Case manager Service will also participate in client recruitment, services, mentorship and job training and placement.

CM was out on vacation from the period of 5/31/2017 to 6/14/2017. On 6/20/2017, CM met with the client to complete Bi-Weekly ILP Review. Today, client was calm and quiet in the meeting. She was dressed appropriately for the weather. Client affects and mood was in appropriate. Client continues to appear to have cognitive impairment and she doesn’t grasp information. e.g. when try to explain herself she will have flight of ideas. She doesn’t provide a complete story of the event before she jumped into another subject.

The patient arrived on time for the counseling session. Reports stability on her dose and denies the need to increase on her methadone when offered by the writer. According to the patient, she is scheduled to meet her assigned psychiatrist today at 9am. The patient asked the writer for assistance with rescheduling her AMR appointment time on the 31st of October from 9:30am to 7am. The writer called Nurse Rose to see whether or not the appointment time can be change and the patient request was granted. The patient then updated the writer about the status of her daughter and her son, at which the patient shared that they are both are doing well. Addressing the NA log, the patient said, " Oh, No....I forgot, Charlene. I am so sorry...I need

D) Client met with his counselor for his 1x1 session discus his exited plan and what he needs to follow through with once he graduates the program. Client has completed his step work along with other objective that’s list on his treatment plan. He has been compliant with the Quest House and FSC program rules and regulation and he started opening up more in the group with his peers about his struggle in out of the program. A) Client appears to be more stable in his recovery as time goes by, he seems happier and can’t wait to start his journey in recovery. P) Counselor will continue to encourage client to keep working and on himself and to stay strong his efforts to maintain a life without the use of any mind altering chemicals.

Court administration is very important in local, state and federal court systems because it pertains to the daily management and administration of the courts. The American court system has become complexed throughout several decades, and traditional methods of managing, organizing, and leadership are not accommodating the increased demands of today’s court daily operations.

SC called Pa and spoke to Pa. Pa reported that she is receiving services as outlined in the ISP. Pa stated that she is please with her services and feels that they meet her current needs. Pa reported that she is schedule to have surgery two weeks from now to remove two hernias from her stomach. She also, reported several medication changes. No falls, ER visit, hospitalization was reported by Pa. SC informed the CG that Pa is up for a home visit in January, 2016 and then SC will assess Pa for the increase and submitted it for review. CG ok with waiting until SC visits in 01/2016. Pa confirmed that he is receiving services as indicated in the ISP in the following type, scope, amount, frequency and duration: Pa receives 4 hrs x 7 days via PPL consumer

D-The patient attitude appears to be positive as he reports that he is pleased about his dose increase and did not have to use yesterday, at which this writer provided a positive feedback. The patient reports he feel he is stable at his current dose. The patient stated that he is working on his towards his recovery progress. The patient admits that he hasn't contacted CHS to reschedule his medical appointment and behavioral health services. The patient stated he will schedule the appointment. This writer urges the patient to do so and keep this writer updated. The patient then discussed how his daughter is his motivation with a smile. This writer addressed the AWOL status on 03/04/2016 and the patient reports he had overslept. This writer

In the last two decades, nursing care delivery has changed tremendously. According to Finkelman, (2016), nursing care models attempt to organize the process of providing nursing care so that there is consistency in understanding what care is required when patients are unable to provide for their own needs, and how this care should be carried out. The model of nursing care used varies greatly from one facility to another and from one set of patient circumstances to another. Nursing care models may be found in any area where nurses are practicing and providing care: home care, long-term care, acute care, and psychiatric and community settings. All of these practice areas involve the nurse interacting with patients. In my nursing practice in