Patient Voice Self Reflection

The facts of this case are that Dr. Guiles who is self-conscious of his prostate cancer diagnosis is treated horrendously when he finally decides to have surgery ( Buchbinder, Shanks & Buchbinder, 2014). Considering that Dr. Guiles is already sensitive about his condition, his unbearable symptoms are not helping matters (Buchbinder et al, 2014). Upon arrival at the hospital, he is treated subpar. The admitting clerk is rude and unbecoming to a patient who isn’t feeling well and who is embarrassed about his sickness (Buchbinder et al., 2014). To make matters worse, he has to find his own way up to the floor by walking, which causes him to be even later in checking in because of the need to stop frequently to urinate as well as having difficulty in walking (Buchbinder et al., 2014). Once he arrives on the floor, the charge nurse is not welcoming and unprofessional (Buchbinder et al., 2014). After figuring out what to do with the paperwork; and the nurse aide delivers Dr. Guiles to his room, the nurse aide does not offer to help settle him in (Buchbinder et al., 2014). Therefore, Dr. Guiles is faced with battling obnoxious family members who are on his bed and to make matters worse someone is in the bathroom which doesn’t help his need of having to frequently urinate (Buchbinder et al., 2014). When the issues are brought up to the charge nurse, the charge nurse accuses Dr. Guiles of wanting preferential treatment

The patient asked this writer if this writer cannot talk to her mother and advocate for the patient to the clinic's TEAM about the urgency of getting her bottles. This writer was willing to talk to the patient mother and will try again, to advocate on the patient behalf to get her bottles. However, addressing the mental health portion, the patient stated she has to figure something out about the transportation barrier as no scheduled has been made with CHR due to her barrier. Please note, the patient is no longer seeing Dr. Kuru as the psychiatrist no longer works for CHR. The patient prescriber for her medication is her

Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.

He reports the patient’s roommate was subsequently evicted from his home after the landlord inquired about the ambulance visiting. He reports he contacted her father concerning the patient residing within the family home, but the father has said no. In addition, he reports he has attempted to contact her uncle but has been unable to make contact with him. He reports he has attempted to make contact with her said friend who is considering allowing her the opportunity to reside with her but she has not answered her phone and he has been unable to leave a voice message. He reports no one wants her in their home, and the patient has “burned her bridges” with family members. He reports her family would benefit from counseling. In addition, he reports her family has high expectations of CPS. He reports her current case was not going to close within 12 days of 06/30/2017. In addition, the case will not

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

On august 13, 2016 I was assigned to follow one of the ICU Nurse. It was a very calm day. She had two patient one was more critical than the other. Both patients were on the ventilator because they had to be intubated the night before. The lady is obese and had gastric bypass surgery two years ago and suffering from severe sleep apnea, but the patient is non-compliance to the CPAP treatment. That was her second time being intubated. She was admitted for seizure monitoring because she was constantly having seizures the day before while she was at home. Due to the fact that she did not want to wear her CPAP machine while in the hospital, after pain medication was administered she was found unresponsive, that was the reason for her intubation the night before. Patient was on intermittent suctioning, she has sinus tachycardia . I had the opportunity to observe some of her daily care. The patient was on fentanyl but when the Dr. try to wean her out of the ventilator she stop breathing, therefore, the DR. discontinue the fentanyl temporarily in other to retest her later.

Patient A was assigned several nurses during her three days stay at the hospital. Everything went well until the second night at the hospital room. A new nurse was

D- This writer met with the patient about his request for a change of counselor. According to the patient, he reported that his assigned counselor, Cherron does not make himself available for schedule appointment or even at the exact time of the appointment as the patient tends to wait for a quite some time. In the beginning, as per patient, his assigned counselor was punctual but everything has changed since the patient made a compliant against the counselor for not informing the patient about the need to validate his Rx Scripts and the severity of the matter to avoid entering a detox treatment. Since then, the patient feels that his relationship with his counselor has changed and feels that Cherron tactics appeared to be vengenaceful whereas

Counselor met with Pt. for his monthly individual session. Counselor and Pt. discussed his progress in treatment, any medication issue, any triggers and acceptance of his TX plan. Pt. signed his Record Service sheet. Pt. indicated that he does not attend the clinic Tuesday, Saturday and Sunday and he likes having more time in his schedule because he likes to take care of his business and different errands. Pt. verbalized how hard it is to stay away from his business because worried about his employees and clients. Pt. stated, “The business is like my kid,” Pt. spoke about how he is thinking about opening a second shop around this area. Pt. commented that he isn’t experiencing serious side effects and prescribed medication is working well. Pt. informed this

In the midst of attending a party with his friends, a random, ricocheted bullet pierced the right side of his head while he was trying to break up a fight. The bullet blew away part of his skull and lodged into his brain. When he arrived in the trauma bay, medically he was dead- no pulse, no spontaneous respirations. His family was forewarned that if he woke up there was a strong possibility that he would never speak or walk again. The patient- B.H., was a seventeen-year-old high school senior, who was class president, and captain of the football team when he was shot. During his month long stay in ICU, the hospital staff worked around the clock to ensure that his issues were properly managed. Despite all odds, B.H. is currently in his senior year of college, plays semi-professional football, and works two jobs. What was particularly fascinating, was the way the physicians were able to prioritize and execute their management in a dire situation. The intricate thought process of managing the patient as a whole,

H had respect for the nursing profession and suggestion render for the care of the patient. The physicians did not examine the patient for himself to see if I have a valid point, he continues to treat the monitor and not the patient. As I analysis things that I could have done differently, one choice I could have done was go up the change of command until the problem was fixed. Another action would be, to insist on DR. H walking 20 steps to the patient room to examine the patient when I notice the change and not just the monitor and labs. I could have stopped the fluids until the patient was examined as well as the x-ray was done. Unfortunately, the patient passed after a long code. That day has change how I handled conflicts with a physician. That day I felt that I had fallen my patient. I go up the change and I don’t care if the physician feels that I’m going over their heads. Furthermore, I am not timid when it comes to voicing my concern about how the doctors are handling patient

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

Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to wait few minutes after

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 situation in scenario 1 could leave a patient very disappointed due to lack of effective communication.