Centerpoint Medical Center Observation

Scenario 1: You are the healthcare administrator of a nursing home. You are informed by your Admissions Director that a new memory-impaired resident has been admitted into your long-term care unit. The staff is concerned about the involvement of family with your resident. Family members from out-of-town arrived and expressed concern about your resident’s do not resuscitate (DNR) orders which were authorized by the Power of Attorney of another family member. A quarrel erupts in the nursing home with family members voicing their opinions loudly. You arrive on the scene and are immediately told by the visiting family member, “Do you know who I am? I am a supervisor for the Department of Health and Human Services and will not hesitate to have your facility surveyed for noncompliance.” What do you do?

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.

The recovery nurse, who attended to the care of the patient during her post- anesthesia, this nurse had attempted to contact the mother by overhead paging her to the waiting area, the recovery nurse was unaware that the mother was not in the facility and needed to call her. The recovery nurse had a negative approach, on the hand off process that this facility has in place

In the complaint, it is alleged that Dr. Rehman breached the relevant standard of care by discontinuing the pharmaceutical Glucovance, and by ordering insufficient monitoring of Ms. Green’s glucose levels; and that Millennium Health and Rehabilitation “failed to property monitor the deceased, ignor[ed] panic values on her labs, [and] misinterpreted the order discontinuing the Glucovance without order of [Dr.] Rehman.”

During a review of the master file the following documents were located: Case Assignment Sheet, Uniform Complaint Report, Dr Smith’s summary and records, Mercy Hospital Records, and MRR done by Dr Voss on May 04, 2015.

On 6/11/15 at 2:00 pm, I called Dr. McClain at his listed home number to confirm he was still in the area and to inquire if he would be available for an interview at some point. Dr. McClain began explaining that to his knowledge all of the complaints had been “kicked out” except for one case involving an ileostomy reversal. That complaint resulted from him being told not to have contact with patients since he was under investigation. The patient was upset because they could no longer see him, McClain stated.

The clinical staff was told by the operator that someone did contact them and an officer is on his way.

The patient went as far to admit that she currently is having a hard time breathing, but has an appointment with her gynecologist on Monday. This writer advised the patient that if she has difficulties breathing she will need to go to the ER immediately and be medically assessed by Nursing. The patient started crying about she does not want to be medically assessed as she needs to return her boyfriend vehicle so that he can work. This writer informed the patient about the seriousness of her health comes first. This writer called Nursing Chrystal, but no response. Then this writer and the patient went to the Nursing Director office to be medically assessed. According to the Nursing Director, she advised the patient to go to the ER first and will not be dosed today unless she provides proof of documentations of her visit. Again, the patient fussed and then says, " I am fine, it's not serious," however, the patient was advised to follow medical

On Wednesday, April 19, 2017 at approximately 9:15 am Investigator Cindy Hercules and I Obtained the following statement from the complainant patient Phyllis Burrell - Karriem.

The main ethical issues that presented in the case scenario is maintaining privacy and confidentiality. “Privacy is limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person” (CNO, 2009, p. 7). Nurses recognize the importance

During high school, I was a member of the New Visions program; through the program I was able to observe and volunteer at Monroe Community Hospital and Strong Memorial Hospital. I spent four days out of the week at Monroe Community Hospital and one day at Strong Memorial Hospital. I was placed on many different floors. For instance, I was on a geriatric PT floor of Monroe Community Hospital where I watched therapist work one-on-one with patients. I went on room calls with therapist to observe care outside of the PT facility and watched how they set up patient care plans. Also, I was on multiple nursing units at both hospitals, where I would push patients in wheelchairs to their desired destination and help feed patients at lunch time. I was

This paper discusses the Patient Center Medical Home (PCMH), which is used by many HealthCare organizations around the United States (US) and the world. The goal is to look at the impact Patient Center Medical Home (PCMH) and the outcomes for Americans, and help Primary Health Care adopt the Patient Center Medical Home model. The key factors the paper will focus on are the cost and access to healthcare services how to improve PCMH in the US and challenges that faced by PCMH adoption.

First week at High Point Regional Hospital was a bit nervous. I didn’t know how the technologists there would interact with me. I worked with Kim, Sonya, and Debbie. All of them seems alright to me. On Tuesday, I didn’t scan anything, I mostly observed the technologists. I helped prep the room, wiped down the table, and put on a new sheet on the table . I’ve learned that the way they scanned their lumbar spine here are different than in Lexington Medical Center. Here, when scanning lumbar, it should only cover 5 disk space, top and bottom field of view (FOV) doesn’t overlap. High Point Regional Hospital has 2 MRI machine; a Siemen Espree and the old Siemen Symphony. Lexington Medical Center has Siemen Aera (newer machine), images are