Met Mma Narrative Report

The patient arrived on for his counseling session. Reports stability on his current dose and denies the need for a dose increase or decrease when offered by the writer. The patient was made aware that he will be reassigned to counselor, Scott effectively immediately as his new assigned counselor will schedule his next session. The patient reports of no update with his medical pertaining to a referral to another PCP as he is currently still seeing the same medical provider.

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

Her procedure was performed by a physician in an outside department rather than the oncology advance practice providers. As a result, the physician performing the procedure did not have personal knowledge of the test required and was dependent on our providers to communicate this information. Had her procedure been performed at the bedside, the team would have likely been performed in the afternoon. This may have prompted further communication of the need of this test during bedside round with the attending or a second advance practice provider who would have likely done the

Today, MSC visited Maria at her residence for a face to face visit. When MSC walked in Maria was having a snack at the table. Maria waved and greeted her staff. MSC said, Hello, How are you?" She stated that she needs to talk to MSC in private after she finishes her food. MSC spoke wither Medical Direct Care Counselor Marie Rose. She stated that Maria has been doing good. He is cooperative at times, but requires redirection. Maria stated that she is medically stable and her behavior has improved over the past few months. She is communicates her wants and needs effectively. Maris continues to go to all of her medical appointments and enjoys attending program. Maria goes on all community inclusions and makes suggestions on places she would like to go. She struggles with balancing money, staff continues to assist her in budgeting.

Met with PO for 30 minutes individule session. The session was focused on reviewing treatment progress and discuss continuing care plan.

This is 36 year old whte female. Patietn is complaining of severe earache 9/10. Patient reports she was seen at St.Vincent ED yeasterday, but didn't get treated and was told to take ibuprophen and flushout the ear with OTC. The patiet is tearful, and scared. Patietn also reports alll of her current Rx been out for past 2 weeks and haven't been taking any of her Rx. Patient denies chest pain, SOB, N.V/ D, or fever. Patient reports depressive moods, but denies thoughts of suicide or homicide.

The patient is upset that his dose was decrease and at first, struggled with the

Patient denies chest pain, SOB, N/V/D. Patient is a current tobacco user, denies use of alcohol or illicit

The multidisciplinary team meeting is an example of the process in action. Many clinicians are present. Most will be in a position to help formulate the most appropriate management for the patient. The doctor directly responsible presents the present situation and the relevant background. The assessment will include a discussion with the clinician to clarify the clinical findings and a joint review of the results of all relevant investigations. Recommendations will be agreed by all present. These will be documented in the patient's records for implementation.

D-The patient reports she is stable on her current dose and haven't experienced any withdrawals and/or cravings. The patient further mentioned that work is going okay, but still exploring other job opportunities. This writer provided positive feedback towards the patient's recovery process. In addition, the patient reports she has to do a pneumonia test as it was suggested by her PCP today. This writer requested for the patient to detailed if she's experiencing any symptoms and would like to consult with the clinic medical doctor. Based on the patient, she reports she was experiencing some backaches, but now, feels okay. During the remainder of the session, the patient discussed her plans for the Easter holiday and also shared with this writer that today is her son birthday.

“I understand. I want the pills.” I said and reaffirmed my thoughtless decision to Dr. Wilkinson.

The patient must pay close attention to signs and symptoms in this stage. Signs may

It was near the end of a clinic day when I escorted a mother and her four year old daughter to room three, laid out her chart, and put up an x-ray of a the child's knee. Once the doctor had finished with the patient in room two, walked over to the x-ray display, pointed to four small pointed bone protrusions, silently put up the x ray of her shoulder, pointed to another three then sighed. After turning to see what was probably a confused look on my face, he said a single word- tumors. I had seen several other patients with cancer; usually it was caught early, and treatment began very soon after. However, that was not the case here. I stood discreetly by the door as it was explained to the patient's mother, with the help of a translator as the doctor didn’t know Spanish and the mother English, that in order to give her daughter the best possible chance, they would have to take her four hours north of here to a hospital in San Antonio. The mother replied in a small voice that that wouldn’t be possible

To begin the session, I decided to talk about what happened last time to continue gaining report and to show that I listened to what she said at the first meeting at 1:00. I asked her what she would like to get out of treatment and the reason why she came in since last time we were not able to really talk about why due to having to do paperwork. I also gave her time to talk about why she came in, validated that she has been through a lot and yet she still came in to see me (2:36), which also helped me identify the present issue of her losing her mom and hasn’t been able to grieve. I asked more questions about how she found out to see how that has affected her, which was a good open-ended question because she explained a lot of the process of how she found out about her mother passing away. Validated how

Nausea is nothing to worry about for one who is pregnant; just as Amy Fitzpatrick had no concern until her symptoms steadily worsened to the point of being severe. Amy's symptoms went from a continuous queasy feeling to a loss of appetite and being unable to stand strong odors. However, she still viewed this as a normal part of the pregnancy and went to Virginia to visit family despite being unable to sit up the entire trip. During this time, her condition began to deteriorate at a faster rate than before. She was now unable to hold down any food or liquids and she was eventually admitted into a hospital where she spent a few hours receiving intravenous nutrients. However, the obstetrician didn't consider prescribing pills due to the fact