Eagle Ridge Hospital: Client Scenarios

FAMILY – A Family is my learning center for life and our shelter in times of storms and problems.

I was just two weeks into my internal medicine rotation at Suez Canal University in Egypt, when I encountered a case that I still remember to this day. Ms. Rafat was an elderly diabetic patient that came into our clinic complaining of a persistent wound on the sole of her foot. Upon removing her boots, her complaint turned out to be a foot ulcer with an infection extending to the first and second metatarsal bones .Unfortunately for her, we had to break the news to her and her family that her foot would need amputation. Ms. Rafat was understandably upset but took the news in stride. Following up on her case, I learned that after the surgery, the blood flow to her leg became increasingly poor and she had to return to have a below the knee amputation. Ms. Rafat ended up dying of pulmonary embolism as a complication of her second surgery. This case stayed with me not only because it

Tulsa Memorial Hospital (TMH) is one of the nine acute care hospitals that serves in the general population area. Historically, it has been highly profitable due to its well-appointed facilities, excellent medical staff, good-standing reputation for quality care and its ability to give individual attention for each of its patients. The hospital, in addition to its inpatient services, operates an emergency department and an urgent care center located two miles from the hospital across the street from a major shopping mall.

The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer involves implementing a multitude of strategies to prevent amputation of the limb. This allow for decreased rates in mortality and can increase quality of life. Adequate wound management such as debridement, and offloading techniques should be instilled. Furthermore, education by the provider would be of critical importance for Mrs. Smith in terms of consistent foot care and management of her disease process (Yazdanpanah, Nasiri, & Adarvishi, 2015). Due

Arrowhead Regional Medical Center (ARMC) is a 456-bed teaching hospital located in Colton California. Out of the 456 beds, 90 beds are behavioral health and 366 are inpatient hospital beds. ARMC is a comprehensive inpatient and outpatient health care facility providing multitude of care including: primary care, specialty care, trauma care and houses the only burn center for four counties. Moreover, ARMC has 9 residency programs which are accredited by ACGME and AOA, both are known entities in graduate medical education. Furthermore, Arrowhead Regional Medical Center’s Ambulatory department operates over 40 specialty clinics and 4 family health clinics. Three of the family health clinics are off site located in Fontana, Rialto and San Bernardino. ARMC covers about 98% of Medi-Cal patients through the coverage plan of IEHP and Molina.

On 4/14/2016 SC completed monitoring phone call with Pa's dtr and primary informal Lynda. The Pa was hospitalized at Mercy Fitzgerald Hospital on 02/23/2016 reason unknown. The Pa was discharged to Manor care Health Systems Yeadon, skilled nursing where she stated for over 30 days for rehab. The Pa was discharge home on 4/5/2016 with skilled care from Mercy Home Care. According to Lynda the Pa had no falls, or new health problems or medication change. Lynda reported that the Pa had her first post hospital visit with on 4/14/2016 by her visiting nurse practitioner from visiting physicians. She also stated that the Pa visiting nurse from Mercy’s health is scheduled to visit the Pa on 4/15/2016 followed by PT. The SC asked if the current services are stilling

In this program, I was taught the basics of working in a hospital, such as how to read medical signs and use a wheelchair. I was able to interact with a wide variety of individuals, including residents, doctors, patients, and more. I furthered my knowledge in the medical field through experiential learning. At first, the hospital seemed daunting due to its size and structure. However, as I journeyed through the program, the hospital began to feel like home.

I have had multiple clinical practices, however, out of all the experiences during my shifts, there is one particular event that holds great meaning for me. This event happened on my fifth clinical day of this semester, which was the day I first dealt with two clients.

Trinity Community Hospital strives to grow its service volumes and operate efficiently in order to produce capital for future investments. Trinity’s commitment to the community is to provide every patient with care and support. Trinity Community does not currently operate orthopedic services, but has a vision to become a premier provider of orthopedic services.

Trinity Community Hospital has experience a steady decline in use in the past few years. To reverse this declining performance trend, option would be to develop a new Regional Orthopedic Center.

Ms. Thompson resisted compliance with the new Occupational Safety Administration requirement because she’s comfortable in doing things the way they have always been done. Especially since the surrounding hospitals were not changing she felt that there was no need to change either. Also she felt that training would take her staff away from doing their job. It would also cause them to work more and she doesn’t feel like the change is worth the cost.

On my drive from Columbia to Bamberg at 6 a.m. on Friday, I never fought that I would be embarking on an experience that would be the most meaningful to me. I arrived at Dr. McAlhaney's Family Practice and right away was ushered to her back office full of two nurses and office assistants answering to her demands. She told me to quickly grab a cusp and meter for a patient. This was the first time during shadowing a physician that I was expected to be on my feet and ready for anything. During this experience, I saw patients who were my family, friends, and neighbors. I saw people from my church and school, and even the person who fixes my sandwiches down at a local restaurant. This time was different for me because I felt that all these people

Clinical this week was informative and very different because of the unusual setting. I had the opportunity to go in the community with my preceptor, and participate in an admission of a new patient. The assessment and data collection of this patient was similar to what is done within the acute care setting. We proceeded by asking subjective and objective questions to the patient to better understand that specific patient needs. We did assess, the patient environment for her safety, explain and administered medications, coordinate care services and equipment, also counsel patient and their families.

I am coming to you to ask a favor that I hope both of you will oblige in.

The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer requires implementing a multitude of strategies to prevent amputation of the limb. Adequate wound management, including debridement if required, and offloading techniques should be instilled for Mrs. Smith. Furthermore, education by the provider would be of critical importance for