CHIEF COMPLAINT Left great toe pain. SUBJECTIVE Mr. Loving is a 30-year-old patient who is seen at the medical clinic today in regard of his left toe pain. Patient reports that his toe is in pain but compared to before it is much better, much improved. He still has some pain there, but he refused to have nail removal or he had refused the provider to touch to his left toenail. He stated he wanted some medication for pain and he also wanting some bandage then he can put topical antibiotic and a Band-Aid. Patient refused any medical option or suggestion. He stated that stay in the NHU and he take medications as directed. He stated that he just wants a bandage and he does not want to have anything further in this regard. OBJECTIVE Vital
The Department of Human Resources received a report on Ms. Sue Salter on 9/17/14 alleging Ms. Salter a paraplegic who is paralyzed on her left side was living in a home with no water, power, and had an inadequate caregiver. During investigation, utilities were reconnected and Hospice service provided. Hospice stated Ms. Salter was losing notable weight and found lying in urine during visits. Due to this, several bedsores increased and the doctor ordered a catheter and low air mattress. Ms. Harville, the caregiver was educated on wound care numerous times and demonstrated a working knowledge but choose not to administer wound care.
is very pleased with the quality of care she recived during her stay, after further conversation with her I noticed a couple of things that would have improved the quality of care. there was a dicrepancy in the care she received in two different units. while in delivery unit all the call bells were answered on time and the nurses checked on her frequently, same couldn't be said about the nursing care in the recovery unit. A couple of incidences stood out that could have been handeled in a different manner. First one was that when S.D. received her meal and she wanted to confirm that it was a vegetarian meal. The nurse said that she was sure the meal ddn't have any meat in it because that’s what her chart said. but this response didn't satisfy the ptient and she decided not to eat the meal. Second incident was more of a safety concern compared to the first one. S.D. was advised to call for help before going to the bathroom because of pain and swelling around her stiches. But during one instnace while she rang the bell, a nurse came in and told the patient that because her husband was sleeping in the room he could help her to get to the bathroom. This incidence raises a serious safety concern for the pateint. If an untrained healthcare professional such as her husband helped her get in and out of the bed, he could have pulled on the stiches and caused a potential
HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,
Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their
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
Mr. Williams testified that he has an open sore on his big toe, and has been diagnosed with diabetic foot ulcer. Mr. Williams testified that he has constant foot pain, and he cannot stand for long periods. Further, Mr. Williams testified that he is not working because his last place of employment required him to wear steel toe shoes. Mr. Williams stated that he needs assistance with getting some special diabetic shoes, because of the wound on his big toe.
The healthcare team honored the patients’ wishes as best as possible; the only time we bothered the patient was when we changed the dressings on the pressure ulcers located on the anterior portion of the left foot and right buttocks and when we provided the patient with PRN pain medications. Since this is a Medical Surgical floor, we were required to do one assessment, and that occurred during the time the health care team went in as a group to clump all of the care up and do it at one time. The only negative experience that had occurred was when the patient was expressing non-verbal signs of pain – and from that point, we worked quickly to give him his PRN pain medications to manage it.
The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.
M was taking a look at his leg that was injured but seemed to be healing. All was thought to be well until one office visit the doctor went across the hall to check on another patient who seemed to have an infected leg. The doctor left the door open where confidentiality here was obviously not being taking into consideration for the patient he was seeing as well as others who were able to hear them. Since the door was open, his parents noticed that he did not change his gloves while entering that other room and came back to check on their son with no gloves on. Dr. M was concerned about Jacobs leg and told him to come back the following week while treating it with antibiotics. The following week he comes back only to see that he has developed osteomyelitis. This was the same infection that the other patient developed while under the care of his supervision. Jacobs delay in his recover cost him the opportunity to play football and a college scholarship. Jacobs’s parents then resorted to suing Dr. M because of his negligence and lack of medical
During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to
The negligence of this incident had a negative impact on the patient’s family members. Approximately 25% of cases involving medical negligence involve poor nursing care. Another negative aspect was patient’s family follow up was poor resulting in lack of importance highlighted on the pressure wounds. Ashley (2003) states nurses can be sued for malpractice, this means he or she is being sued for “negligence”. Furthermore, the nursing health professionals can lose its credibility among a community as they failed to provide a holistic care for the patient. However, a positive outcome was nurses were able to reflect among this evidence based practice to assist in better quality in patient
As a doctor, to prepare myself to take on this case I would have to process a substantial amount of information and use my best judgment to conceive what the best plan of action regarding this case should be. Reviewing the four key principles in medical ethics: nonmaleficience, beneficence, respect for autonomy, and justice, would prove to be very helpful. After reviewing and consulting with my peers I would most likely conclude that the patient is the one receiving the service and is to be put first above all other factors contributing to the situation.
Maria Niceforo, a 75-year-old woman receiving in-home nursing care, had died of infection due to numerous pressure wounds (Le May, 2016). She was admitted to the hospital presenting with a bleeding pressure wound across her back and legs that had penetrated through the bone (Le May, 2016). It was also observed that the wounds were soiled with urine and dried faeces (Le May, 2016). She was receiving in-home support from registered nurses, who according to her son, were not consistent nor reliable in their care of Mrs. Niceforo (Le May, 2016). Another contributing factor to her death was inadequate communication and documentation of her treatment (Menagh, 2016). For example, one of the nurses had reported not providing treatment to Mrs. Niceforo's bottom as she was not aware of it (Menagh, 2016). I was quite
Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.