Dr. Seagraves : An Elderly African American Woman

African- American female, 71 years old, has been admitted to the hospital from her primary care provider ten days post-op following a right below the knee amputation. Her only complaint is that of abdmonial pain. Her vitals are as follows: BP 100/70, HR 122, RR 22, Temp 101.1, and oxygen level 96% on room air. Glucose level is 563mg/dl on glucometer and the patient states that she takes a round white pill for her diabetes. She has also been diagnosed with hypertension in the past and takes a white oval pill for it. Head to toe assessment that has been completed noted a foul smell omiting from the bandage where the leg has been amputated. Clearly this patient is exhibiting clinical signs of sepsis. The initial thought is that the source of infection is the surgical wound since the foul odor is present. The next few hours are critical in initating treatment for sepsis. Multi-organ failure can result if treatment is not received in

“That evening, the boy next door groaned like he was dying. I knew what it was like to be a child in pain. Screw this. Casanova, a SIGINT medic named Rick, and I did a hard entry on the boy’s house…We gave hime intravenous antibiotics, bandaged his wounds, and injected each butt cheek to stop the infection. Then we vanished” (Wasdin & Templin 97).

The RP stated she asked a nurse regarding how the resident could have acquired gangrene in such a short time; the nurse believe it was due to the resident sitting for an extended period of time with her shoes

I do not have a written account of the scrub nurses or other Operating Room staff testimony as to what actually happened in this Operating Room. It would be speculation on my part to assume the worst of the physician without having all the details before me.

I wandered throughout the hospital hallways. An unfamiliar place to me, thus I began to explore. It was 9 am and some patients had already lined up to see their physicians. I was shadowing Dr. Waterman, a family medicine resident. I followed her on the morning patient rounds, she would introduce me to her patients, asking for their permission for me to observe. As the shadow, I tried to remain imperceptible but observant. That day, I got exposed to different medical disciplines. In one case was an 83-year-old Caucasian female with dementia. She had come with her two children who broke down in tears when she couldn’t even remember who they were. Dr. Waterman’s response transcended beyond patient care and got families involved. She would report

The father decided to do the biopsy and they took her back. Studdert removed an inch long ellipse of skin and tissue stretching from the top of the foot to the tendon. Then, he removed some of the muscles at the center of the redness. Both samples were sent to the pathology department where a dermatopathologist had later confirmed their suspicions. When she was taken into surgery, the destruction was obvious and they had questioned the need for an AKA or BKA. However, they decided to trust their guts again and did a debridement and flushed out the muscles. Two hours later, she was transported to another hospital and put in a hyperbaric oxygen chamber for two hours to boost muscle repair. The following day, she was taken back into surgery to remove more of the infected muscle and they decided to increase the oxygen treatment to twice a day for two hours. Twelve days later, she was released from the hospital bacteria free. A patch of skin, about sixty-four-square-inches, had been removed from her thigh and used as a skin

Today, I observed Dr. Koch in podiatry again. The first patient I observed had half of their right foot amputated, which might have been from osteomyelitis. The patient received an operations to amputate half of their foot. The only problem was the recovery time after the operation. Normally, patients wait at least two weeks to remove any sutures on their feet after an operation. However, one of Dr. Koch’s assistants had removed the sutures from the operation one week after the operation instead of two. So when the patient tried to put any weight on the foot after removing the sutures, the wound instantly bursted open. Some time ago, a vascular surgeon bypassed the veins in the foot and removed the right big toe along with the metatarsal.

Please don't call me doc; I’m a nurse she'd asserted. Her voice echoed with confidence. She was a stern woman. Mary was her name but I only ever referred to her as Commander Brown. She wore a kaki military uniform with a silver leave pin that you'd never see under her white trench coat she vastly moved in. Her assertive statement reciprocated in my mind through out the day; as several patients made the mistake to call her Doc. I was quite as I scurried beside her from room to room seeing patient after patient. I observed everything she did as a nurse practitioner. I was twenty years old, and a brand new EMT in the Navy words rarely escaped my mouth. As a Corpsman/medic my job in the navy was to rotate EMT duty, during the days I wasn’t on ambulance call I was busy assisting Commander Brown. As a newbie I was forced to work along side Commander Brown everyone in the clinic was a bit more seasoned and refused to work with her. She was demanding, strict, and scrutinized every detail. She was tough on everyone even her patients. Day in and day out I shepherd to her call. I worked diligently checking and rechecking orders, chart notes, and studying the diseases of her patients. I sensed I had to be impeccable to

Mrs. Smith Case clearly demonstrated the lack of duty to care from healthcare Providers (Nurses, Physicians, Residents) involved in this case. Certainly, Patient was admitted to the hospital for surgery and post-surgical care but the proper care was not provided and the patient contracted a staph infection which proof that the duty of care was breached. The injury, in this case, was evident. The patient not just contracted staph infection but also develops empyema due to the accumulation of pus in the lungs. Definitely, Cross contamination was the cause of the infection and the pulmonologist Dr. Holly Brighman consider this the reason of the infection. In addition, the nurse on duty was a witness of the attending and medical resident actions.

As we walked into the operating room, healthcare professionals reminded me to stay two feet away from the patient. Nurses, doctors, and the patient herself along with her husband were present in the room. The alarming statement that Dr. Shelton uttered revolved in my head. Surgery was about to begin, so I figured there was not enough time to ask questions due to my extreme curiosity.

I sat in the hospital’s waiting room in utter silence. There was another elderly woman in the waiting room, crying in the corner, holding a photo frame in her arms. The halls of the hospitals were empty, apart from hospital staff and patients who occasionally passed by. They reeked of disinfectant and the smell of old people. The flickering of the fluorescent lights started to annoy me. It had been approximately two hours since the surgery had begun and I had become increasingly tense. The seat I sat on was

　　Imagine you’re working in the operating room; a long rigorous case that has literally lasted your entire twelve hour shift. A frustrated surgeon tosses a scalpel onto your table and as if in slow motion you watch in horror as it bounces and the dirty blade falls right across your fingers slicing through both pairs of your gloves and into your hand. Immediate frustration and panic sets in what if the patient is HIV positive or what if they have hepatitis? How dare the surgeon be so careless! Then in a blink of an eye your perfect little life seems to fast forward in front of you. You where just saying you where so happy you had just started trying for a family is that over now? Will you catch some blood borne

A home-health aide encounters a situation where she comes in contact with her client’s blood, a couple weeks later she isn’t feeling so good. She thinks she may be coming down with the flu and heads to the store for some over-the-counter medication. After a week of running a fever, chills, night sweats, muscle aches, along with a sore throat they schedule an appointment with her doctor. He thinks it 's a common cold and sends her home. Another week goes by and her symptoms have only gotten worse and now she has swollen lymph nodes and has developed some type of ulcer on her mouth. It 's late at night so she decides to head to the hospital.

During my second week of placement, I was working under the supervision of my preceptor, caring for a fifty four year old Samoan gentlemen, Mr.Li (pseudonym). When we went to his place in Mt. Albert at around 11am, he was sitting on the chair and his wife was sitting beside him. Mr Li had left leg ulcer and he developed this in February 2016, when he went to Samoa. According to Mr. Li, it started off with a blister and lead to left leg cellulitis. Mrs.Li (pseudonym) told us that when Mr.Li went for swimming in the beach during his stay in Samoa and he knocked his left big toe. Mr.Li 's big left toe got infected and doctor’s informed them, this is how his left leg cellulitis started.

While our bus crept away from Kolkata, the vibrant sounds of rickshaw horns, street vendors, and tourists faded as we approached our destination, a small building entitled “Prem Nivas: Leprosy Center.” Sitting on that bus, with one year of medical school experience, I felt unprepared to assist in the center’s clinic. However, as I peered around at the internists on the bus with me, their sense of calm was contagious. I took a deep breath, and stood up, not knowing I would leave here to follow their path to internal medicine.