Patient Case Scenario

The patient is a 34 year old black male. The patient reports he is single with 3 daughter ages 3, 11, and 13. The 3 year old live with him. He reports currently live with his mother and brother. The patient reports he has 14 years of education however has not received his degree. The patient reports being on probation for Injury to a child for the next two years. The patient is scheduled to be complete his probation in September 2016. The patient reports Cannabis is primary substances and his last use July 20, 2015. He stated on that day he smoked about 5 joint. The patient also report that he tried Xanax . The patient denies any issues with HI/SI. Patient also reports he is taking his medication as prescribed. The patient appear to be in the pre-contemplation stage of change. The patient next scheduled individual session with the counselor is on Thursday, July 30, 2015 at

Objectives/ Progress: As the Pt. has participate in the AMS Program, he has discontinue his opiates use and his UDS results indicate no evidence of ongoing abuse. Pt. demonstrated treatment maturity and appropriate control of emotions but he has never earned take home privileges because he likes to smoke marijuana and he is self-medicating with the drug as a way to battle depression and anxiety. Pt. does not want to discontinue his marijuana use. Pt. has refused to find and obtain mental health services during previous tx quarters. Patient has experienced treatment regression due to failing to attend November monthly counseling session and receiving an AMS Notice of Counseling Non-Compliance letter. Patient reported daily as instructed by AMS staff and AMS Doctor to receive prescribed daily maintenance medication. Primary Counselor will encourage Pt. to reflect on the negative aspects of his bad habit and the positives associated with giving marijuana up (or reducing). Counselor will be aware that Pt. may doubt that the long-term benefits associated with

The patient continued to use cannabis, alcohol, and cocaine, intermittently. His cannabis use continued to be regular and he was estimated smoking 1/4 to 1/2 oz. of marijuana a day.

JG, a 34-year old Caucasian female presented to the primary care physician office with complaints of losing weight and feelings that "her heart is beating out of her chest". On assessment it was noted that JG had lost twenty pounds in 3 months. JG exhibited tremors in hands, bulging eyes, and pretibial edema. On physical examination there was a goiter, or enlarged thyroid gland noted.

HISTORY OF PRESENT ILLNESS: This patient is a 10-year-old male. He was in a Motocross accident this past Saturday, sustaining tibial eminence fracture, displaced. He presents today for evaluation.

When arrive to room patient was agitated, refusing services from Sitter Jorge Reyes. Patient stated that days ago Reyes refused to give him a white blanket. Reyes explained that was only white and blue blankets available at that time on the floor, that unfortunately on the last couple of days we had limited resources on regard to linen. Patient stated that he was the patient and Reyes was the server and he had to provide whatever he wanted, Reyes answered that he will provide him with whatever he needed, that he had to understand that this was a community hospital, that the linen department works limited hours and was not like a hotel where he was able to request

Patient is a 35 year old female who presented to the ED with suicidal ideation with a plan to cut herself.The patient is from Elizabeth city. She road the bus to Greensboro and caught a cab to Asheboro to see a guy friend. The patient expressed that her friend and her were not able to find a place send some time together, so she came to the Hospital. During the assessment the patient reports feelings of depression and that she has been practicing cutting behaviors with a razor on her left arm. There were no visible cut on either arm at the time of assessment. The patient reports having really bad thoughts about harming herself and contacted the friend she was visiting and husband, which told her to go to the hospital. The patient reports a

Patient is a 27-year-old Hispanic male who presents to CRU from UPC. Prior to admission to UPC, pt. was waving a machete in the streets and bystanders reported to police and pt. was pick up by police. Pt. denies DTS, but endorses DTO with no specify individual. He stated, "I feel like killing people that snitch." Patient endorses using Meth, marijuana, and alcohol. He has a hx of been incarcerated, and was released in 2015. He is alert and oriented x4. His vital signs were WNLs. Patient will benefit from meeting with the provider, medication stabilization, and OP

Patient is a 28-year-old Caucasian female who presents to CRU from Abrazo Central Campus. She is GMH designated, and T19. She is currently homeless. Patient used to be on social security disability due to her hearing disability, but stated she is no longer on SSI. Per collateral, she has been on Meth for about a year now. She reports to be depressed and her primary stressor is losing custody of her kids. Patient is sexually active, and believes her partner is not faithful. Per collateral client reported to the ED nurse that she has been exposed to some STDs. Patient is deaf, and cannot understand sign language. She can read lips. She denies DTO and DTS during assessment. She also denies AVH. She will benefit from meeting with provider to discuss

D-According to the patient she hasn't used any illicit drugs for the past three days, at which this writer commends the patient. This writer discussed the patient 4 months of UDS result as she continues to test positive for heroin and cocaine and her reasoning for her use is due to her anxiety attack. The patient reports that her PCP conducted a referral for the patient to be seen at Brownstone Behavioral Health on 05/05/2016.The patient was advised about the concerns surrounding her footwear as the patient is not wearing proper footwear to help her with her walking. The patient reports that the program director of the clinic spoke with her again about the matter. In addition, the patient reports she is going to see her PCP on 04/5/2016 to

Patient B.C. is a 62 year-old heterosexual, Caucasian female. Patient is single, never married, and has no children. Per patients chart she is spiritual but reports no specific religion she identifies with. The patient is homeless, states that she is a long term resident of Union Station and is unemployed. The patient is a poor historian and there is no family medical history on chart. There is no family involved in her care. Patient is currently under conservatorship per the court due to her family in Houston not wanting to take part in her care.

One component of the reading that surprised me was staff relationship and conflicts. We I hear the term medical professionals, I think of a team of people who work flawlessly together without issues until the read chapter eight in Caring For Patients from Different Cultures. "Problems frequently stem from the differing status of both women and nurses in the United States and other countries. In many countries, particularly those of the middle east and Asia, men have much higher status than women. In general, women are expected to obey men" (Galanti, 2015, p148). In the United States, the Social structure is Egalitarian, which in theory means that everyone is equal. Status and power come from an individuals' achievements rather than from age,

There are many ways families can be involved in a patient’s therapy. There will be opportunities for patients and the families to be apart of the learning process of the diagnoses. Whether the diagnoses is depression, alcoholism, marital and relationship problems, mental illness, etc., I will offer workshops for the opportunity to become more educated on the subject matter. They will then feel empowered and ready to deal with the condition in an optimal way. As a therapist, its my job to inform families about important information. I can do so by scheduling meeting to discuss programs clients can be involved in. Its also important to have open communication to help enhance the patients therapy experience for a better outcome. Family are more

Laura, based on personal experience, beginning your career by working in a clinical setting will prove to be very educational in many ways. I have worked in various large and small clinics and hospitals. I have found that to be instrumental to my success, thus far. I would suggest working in a multi-specialty facility in order to learn where your passion in health care resides. On the job experience differs from classroom experience. Throughout my career, I have discovered that, like your change in desire to work in coding/billing, my thoughts going into various experiences changed as time elapsed.

The patient is a 43 yr old male who states that the last time he was on this unit was July of this year. Patient stated that he was clean for 3 months and relapsed 6 days ago. Patient stated that he relapsed because he was hanging out with a girl. Patient stated that he came to the hospital because he is moving to Connecticut on Wednesday and did not want to go to Connecticut withdrawing. The patient stated on his CQI forms that he has severe difficulty with joining in community activities, has been emotionally affected by his health condition, washing his whole body, getting dressed, dealing with people he does not know, maintaining a friendship, and his day-to-day work/school. Patient also stated on his CQI forms that he has extreme