Level 2A Fieldwork

The PEO model focuses on different characteristics of the person, the environment, and occupations and the relationship between them. According to this model a good fit between the 3 areas provides the best occupational performance (Cole, 2012). “The quality of a person’s experience, with regards to their level of satisfaction and functioning, is the outcome of the fit between the person-environment-occupation transaction” (Strong et al., 1999). Throughout the different changes that people experience across their lifetime the balance between the 3 areas is affected (Strong et al., 1999). By using this model and defining the areas affected, the therapist would be able to guide the patient’s treatment. In this session, we would be looking specifically

This episode of care occurred in a community setting. Sara has a diagnosis of Alzheimer's disease. She live alone, has no children and is a diabetic. Sara does not speak English and her first language is Polish. Sara support worker developed a close relationship with Sara but said recently her dementia as gotten wrong and she sometimes does not remember who she is. Sara has cellulitis on her legs and was refusing to let the support worker change her dressing. She kept saying it was ok and she didn't want it to be changed. The student nurse and the district nurse tried reassuring Sara and explaining why it was importance to treat her leg but she just became more agitated and aggressive. The district nurse and support worker knew it was important

Please explain how psychosocial factors have influenced your clients' ability to engage in occupations during treatment.

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

During my clinical competency placement, I was working on a surgical ward when a registered nurse on duty asked me to assist Mr. A with his shower. This incident happened on the fifth day of my clinical practice. He was a dementia patient and had undergone right knee total joint replacement. She also informed me that the patient did not like too many people in his room because of his dementia. When I went into his room, his wife was there with him. I talked to the patient about having a shower and getting dressed to look smart and he agreed to have a shower. The patient got out of the bed and walked to the bathroom and sat on the shower chair to have his shower. Then I asked his wife if I needs to stay with him to assist with shower, she said she can help him as she was taking care for him at home since he has been diagnosed with dementia. Therefore, I left the patient with his wife to help with his shower and told her to ring the bell if she needs any help. After some time I left the room, the wife rang the bell. As soon as I entered the room, I heard him shouting at his wife and she started crying and left the hospital. So I had to stay with him. He was very capable of washing himself and I just had to help him wash his back as he requested. After he had washed, I asked him if he was ready to get out of the bath, he started shouting at me.

We arrived at Clearview at 2231 Hrs. and took the patient to room 14. I went back outside and began to put our unit back together when Supervisor Carlock approached me and in a very agitated voice said: “WHY DID YOU PULL OFF?” Surprised, I said “What are you talking about?” He said loudly, “I TOLD YOU TO STOP AND YOU DIDN’T!” I replied, “Jeff was telling me not to stop because we had a pulse back.” He said “I DON’T CARE WHAT JEFF SAID, I’M YOUR SUPERVISOR AND I TOLD YOU TO STOP!” I said “Dennis, I think you’re talking to the wrong person, you need to be talking to Jeff, I was doing what he told me to do.” He replied “WHO’S YOUR SUPERVISOR, WHO’S YOUR SUPERVISOR, I AM, NOT JEFF, YOU DO WHAT I SAY!” I said ”yes, you are the supervisor, but at that moment I was doing what the Paramedic in charge of patient care was telling me to do, and what I felt was best for the Pt., since we had a 41 Y/O patient who had a pulse.” He said “I DON’T CARE, YOU DO WHAT I SAY!

Was this patient just that unfortunate? Perhaps. Perhaps her therapists were not funded to talk to each other but could they have talked anyways? Yes, but they chose not to. And to me, that is against the medical ethical principles because it compromises patient care. This was just one of the examples. What about the primary care physician who doesn’t get to see patient’s chart and doesn’t know what to do with the patient after the discharge. I hope she learnt from Carol’s experience.

Talking at me as if I am not a human being. I've been disrespected for too long." Before this writer could say anything else, the Clinical Director, Heather E. walked in to diffuse the situation. The Clinical Director explained to the patient about the clinic's policy and procedure as to why she cannot leave the building to smoke as she is conducting a 3 hour medical assessment due to her medication. The patient was in hysterical tear and share with the Clinical Director as to how things were in the past when patient were able to smoke for 5 minutes and come back to finish the assessment. The Clinical Director informed the patient that particular incident was not allowed and changes were made. Then the patient fuss about why she has to do the medical assessment, even though it was explained to her prior. The Clinical Director informed the patient that no one is forcing her to stay in the clinic and if she want to leave, she

Call received from Ray Logan, patient’s son-in-law upset regarding our treat of him mother-in-law. He reported that she has multiple fractures including seven broken ribs. He stated that his family was promised that the facility would not be too aggressive or rough with therapy before he agreed to transfer her to our facility. He reports that we overworked her and that it left her very fatigued and in great deal of discomfort yesterday (4/12/17). He informed me that his souse was present and request that I speak with her. Monica Bosma, RN Nurse Manager and I went to visit with patient and her daughter Laure Logan. We listened to their concerns and asked Robert Barton to join with us. Therapy discussed and a adjustment made to treatment/therapy

On Friday 06/10/2016 at approximately 2007 hours, Security Officers Omar Alonso (420) and Michael Chin (223) along with Supervisor Steven Evans (407), were dispatched for a (53D) Disorderly Patient in Medical Unit, room #2139. Security staff arrived at 2008 hours and made contact with RN Andres Flores, who stated the patient, Janet Riggs (DOB: 8/21/1965) had gotten out of bed and attempted to leave. Mrs. Riggs is an Altered Mental Status (AMS) patient and had been very combative with medical staff and family members. She had attempted early in the day to injure herself and bite medical staff. Security conferred with nursing staff and it was decided that the patient would be placed in 4 points restraints to stop her from harming herself and

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

I believe that my assessment was accurate and fair. One example I can perceive as a bias, would be my inability to differentiate Western students from other students. Once I completed the fieldwork component of the assignment, I had asked my female friend what was the “Western” look. She explained that females wear Canadian goose jackets, Hunter rubber boots, and lululemon tights. Afterwards, it had hit me. I had been oblivious to my surroundings the whole time. However, if I were to be in an environment that was different from Western’s, then maybe I would be able to see the difference. I also pondered whether there was a male “Western” look or not, but could not come to a conclusion. I also was not able to divide the Asian students into

When I arrived at booking this patient has bad tremors, is diaphoretic, and has increased vital signs, I medicated the patient and made sure the patient was given fluids. The officer states he was like this when the other nursed checked him. I checked the chart and on the sobbing sheet I see that this nurse had just checked this person 10 minutes ago and charted that patient had no signs and symptoms of withdrawal.

Mrs. Green, that’s my therapist’s name. She smelled like vanilla. I hate vanilla. She gave me a list of stretches to do among other exercises and I did them. Everything was going good. As good as I could pretend because lord knew how painful it felt when she would push on my legs. My legs were not the only part of my body that was in pain. Using the crutches had made my armpits become swollen and the palms of my hands to become bruised. I felt absolutely miserable. Mrs. Green wasn’t going to know that. She’s smart I’ll give her that. I could tell she never believed me every time she would ask “How does this feel?” and I would reply through gritted teeth “It’s alright. I’m good”. This sly old lady ordered a body scan. The results showed that I was even more fucked up than I thought. Mrs. Green continued on being the worst person ever (okay she really wasn’t and I know she was just trying to help me heal but I just didn’t want her help). Along with my stress fractures I have a torn meniscus. Great this means surgery. Mrs. Green started writing on a paper. This was to be my new chit. She handed it to me and I swear I would’ve smacked the hell out of her I was so angry. If there was such a thing as smoke coming out of a person’s ears then you would most definitely have seen it coming from mine. On the paper read “transfer patient to RCU”. I was being taken out of my division and placed into the Recruit Convalescents Unit, also known as RCU. They were sending me where all the broken kids go. I wasn’t going to graduate on time. This was the worst possible thing that could have ever happened to

As there are many different professions within the health industry, there are many contributions that it makes to the society and community. Through different occupations, such as psychologist, people within the community are able to target specific help for different requirements. This could be for diseases, physical and mental health (1).