Conducted Home Visit Assessment

For my seventh clinical shift at the Loma Linda Veterans Affairs Medical Center, my assigned preceptor Filipina Gumangan assigned me three patients on the 4NW unit. The unit where I precept is an intensive care step down unit. Filipina’s objective for giving me three patients this shift was to give me an opportunity to continue exercising my time management skills and to practice my reporting and charting skills, and wound care. This shift I was responsible for many clinical duties corresponding to the care of these patients. My patients this shift were Mr. B, a 72 year-old Vietnam War veteran newly diagnosed with colon cancer, Mr. S, a 65 year-old Vietnam War veteran in the hospital for complicated urinary tract infection, Mr. R, a 90 year-old Korean and Vietnam War veteran. Caring for these patients taught me more about the humanbecoming perspective of nursing and showed me about multidisciplinary coordination with peers, colleagues, and more.

They are able to perform patient care by IV and oral medication administration, cardiac monitoring, airway management, blood transfusion, wound care etc… They are accountable to implement family central patient care.

The General Duty of most Registered Nurses’ is to do whatever they can, in their power, to help every patient they come across on a daily basis in a comfortable, appropriate, manner. On the more specific end of a RNs’ duty, a Registered Nurse is expected to and responsible for: performing physical exams and health

I make sure that individuals are provided with care by making sure they are clean, rested, fed and that they are supported in their intellectual, social and emotional needs. You communicate with other people to provide seamless care such as arranging and attending appointments or carrying out treatments.

Preadmission for example, in a nursing home is done by the manager, the patient’s GP or multidisciplinary hospital staff. It is the nurses or receptionist’s job to take the patient’s information and pass it on to the multidisciplinary team. Managers have the job of overviewing the situation. Discharges are granted by the doctor, social worker, occupational therapist or multidisciplinary team. The domestic assistant cleans the room before and after a patient, they also

Monitoring everything, payroll, billing, human resource, scheduling, follow-up with nurses and employees, doctor requests, communicate with the doctor about patients and pre-authorization documents needed for the plan of care, HMO, training, physical therapy for patients.

I supervise the unit’s operations and oversees specific employees at the BHT II and BHPP II level. I am also part of a multi-disciplinary clinical team to provide recovery-based services for consumers in varying levels of crisis. Others include performing nursing assessment, developing a medical service plan and obtains and executes medication orders from psychiatric prescriber. As an RN supervisor, I oversees and maintains medication and medication records in accordance with Agency policies and State regulations. I also coordinates medical care with psychiatric prescriber and PCP. It is my responsibility to serve as a role model of professional behavior at all times.

-Interview patients for medical histories and chief complaints, measure vital signs, and review medication lists

To read and write reports, take part in staff and residents meetings and in training activities as directed

A C.N.A. can work effectively as a member of the health care team by helping a patient or resident meet their basic human needs, for example, assisting with meals. Doing so will help the patient or resident meet other needs such as a small goal with more comfort and ease. In addition, a C.N.A. can work effectively by observing and reporting any changes in behavior or health conditions when providing for the patient's or resident's basic human needs.

I arrived at clinical 0630 and picked up patient information the morning of. I reviewed all assigned diagnoses, medications, labs, and orders with my assigned students, and we discussed our plan for the day. We both took report from the patient's nurse and then Elizabeth presented at preconference. Kala shadowed the Nurse Lead and I helped Elizabeth with brief changes, pericare, and vital signs. I continued to check on both Elizabeth and Kala throughout the day. Last, lunch and then post-conferance.

Ensures safe nursing care for the perioperative patient, including implementation and documentation of safe patient position, adapts care for special needs patients, performs routine nursing procedures including starting an IV and Foley catheterization, and assesses patient condition throughout the perioperative period.

Singh, after the second time of hospitalization for stent placement, became more knowledgeable and wanted to take care of his health. Mr. Singh decided to drive his cab eight hours six days a week and to come home early and do thirty minutes exercises every day. Mr. Singh lives in Elmhurst, and he is going to join the Elmhurst community fitness center that offers free cardio exercises for adults and seniors twice a week in the evening that is a perfect time for Mr. Singh. His son is planning to visit the nutritionist with Mr. Singh to ask about the diet and how to cook healthy meals so that he could give information to his mother. Mr. Singh also got an appointment with the diabetic nurse at the community center to follow up on his regular blood sugar checks and ask questions if any. Good blood glucose control is an important goal when working to prevent complications in people with DM (Forslund, Lundblad, & Söderberg, 2010). Mr. Singh is also planning to visit the podiatrist for his dry and cracked heels as well as a dentist and an ophthalmologist for a regular checkup. Mr. Singh is enrolled in a health home plan where a case manager coordinates the care for people with chronic conditions. The case manager organizes Mr. Singh’s visits under the same organization so that case manager can help Mr. Singh to keep track of his

The purpose of this letter is to inform you of some clinical services we are now offering to our patients. We provide Medication Therapy Management (MTM), diabetic education, and diabetic supplies. Our goal is to supplement what you do with the patients and be a resource for you and them regarding drug therapy issues. Many of these services are reimbursed by Medicare Part D and some state Medicaid programs. If patients not enrolled in these plans request these services, we will provide them for an additional fee.

My responsibilities at this outpatient primary care setting included history taking, chart reviews, active discussions about diagnostic tests and formulating treatment and follow up plans. I learned the basic management plans and goals of care for patients with diabetes mellitus, hypertension and common infectious diseases e.g. pneumonia, UTI