Reflection On Ms. Dewald Meeting

While at Trinity the supervisor gonna call the Activities that were witness today activities that were witness today consistent off the strategies to take me off then off short fast and I have reload a patient karenconsistent off the strategies to take me off then off short fast and I have reload a patients the morning started off within a report give in for all members of securitythe morning started off within a report give in for all this thing is and nurses. Aaron this meeting the unit supervisor very gave with some encouragement to the staff. During this meeting she also informed the nursing staff the clients that were at risk such as the ones with that are prone to bad all sirs the ones are high risk at Falls the ones on isolation precautions. At this meeting was also a clinical nurse educator. On a normal daily basis she is responsible for doing quality rounds and making

Counselor flagged Pt. on the AMS computer system to meet with this writer before dosing. Pt. met with counselor discussed and completed an AMS Dose evaluation to increase her dosage of methadone because she isn’t feeling well and experiencing side effects. Counselor prompted Pt. to talk about her pregnancy, medical appointment and to schedule her monthly therapy session with this writer. Pt. reported that her pregnancy is going well and she is having a lot of appointments at the Bay health hospital in Dover, DE. Pt. stated that they can’t determine the baby sex because her baby has the legs cross. Counselor told pt. that the Bay Health Hospital has a good nicu care unit and professional doctors. Counselor asked Pt.is

During interview Ms. Stoker was alert, aware of surroundings, and answered all questions appropriately and independently. During the visit Ms. Stoker dry heaved into a garbage bucket, and visited the restroom once. The worker was at the residence for about 2 hours. Initially Ms. Stoker was shaking uncontrollable to the point of shaking the entire bed. At the end of the visit the shaking had stopped and Ms. Stoker was smiling and interaction with worker while talking about DELETEbeing a wife and mother. During visit Ms. Stoker received a call from Alacare Home Health. She informed them she was out of her pain medicine but did not inform them she was out of all medicine. Alacare called the pharmacy and was informed she did

The patient was located on the fifth floor and as I was bringing them down the elevator, there was a family member of a patient in the elevator. Under HIPAA regulations, I cannot allow others to view the patient confidential information that I had in my hand. As we got to our stop I told the patient to follow me through the mechanical doors. I told the patient to wait in cubical 2 and that the nurse will be with then in a few moments. In addition, I will be getting them a warm blanket once I come back. I headed to leave the binder at the receptionist desk in the OR where they had another patient pick-up waiting for me. Before I left, I went to get the patient a warm blanket from the storage area that had temperature control. I gave it to the patient and left. Ronnie saw me and asked me if I did the patient pick-up alone, I said yes and he was surprised. Usually he needed to teach others in order to know what exactly they had to do. The only reason why I knew that I had to do everything that I did was because Ronnie told me everything verbally. He did not have to show me what to

She immediately started to worry and stated “What excuse can I give you so you leave me alone?” I responded that we just needed to get ready for the day and we did not even need to call it therapy. Once she sat up she started hyperventilating. My supervisor was in the room at the time and said this was exactly what would happen the last time she stayed in the TCU. After 45 minutes, lots of encouragement, rest breaks and maximum assistance we finally got her dressed and situated in her recliner. While I was documenting the patient was talking to the nurse about how she did not want to have therapy anymore. The nurse responded to the patient and asked her why she was in the TCU if she did not want therapy. In the same week, this patient declined therapy all together and both physical therapy and occupational therapy had to discharge

This writer escorted the patient to Nursing Coordinator Kesley office as the Nursing Supervisor was not in her office. Upon entering Kesley office, Kesley was having a discussion with another nurse and this writer apologized for the intrusion. This writer addressed to the Nursing Coordinator that the patient is experiencing bedbeg and the patient is aware he will not be dose by the Nursing window, only curbside. It appeared that Nursing Coordinator was being abrasive towards the patient as she explained to the patient as to what is needed before the patient can reenter the clinic. The patient then became agitated and shouted at Kesley and says, " Kiss my Ass, " and then proceeded storm out into the lobby area.

D-Met with the patient upon request. Upon meeting with the patient, the patient appeared upset and addressed her frustration in this writer's office. According to the patient, she's upset with her PCP forcing the patient to admit herself to the psych. ward to get on medication. Failure to do so, her PCP will complete the medication protection for her electricity. The patient owes over $3000 and with the protection, her light company cannot turn off her lights. Please note, the patient was pacing back and forth and getting emotional. This writer consolet he patient and validated her feelings. According to the patient, she reports that CMHA informed her that she in order to get into their clinic, an evaluation is needed whereas the evaluation can be completed at a hospital; however, the patient is worried about being admitted. Please note, the patient denies any suicidal or homocidal ideation when questioned.

This writer and the Program Director met with the patient to share an explanation about dosing time arrangement. According to the Program Director, she provided the patient with an explanation as to why he will have to dose between 9am-11:30am due to patient #394 and her husband medical issues. If the patient returns back to work and needs to dose at an earlier time, the patient must provide proof his work schedule for the dosing time arrangement to be changed again. The patient requested for assistance from the clinic to preschedule his Logisticare transportation of which the Program Director and this writer agreed to assist him with. After the discussion with the Program Director, the patient was not pleased and began to get emotional as he feels victimized again. This writer explained to the patient, the patient reason for the dosing arrangement is due to the allegation and safety reason. However, the patient understood the purpose of the arrangement, but he was more concern about getting the earlier appointment rather than a later time. This reiterate about what the Program Director mentioned about if the need to change the dosing time, the patient needs to provide proof for such request. The patient provided this writer with a copy of his ER visit dated for 02/23/2017 of which the patient did in fact received one pill of Klonopin.

D-Met with the patient as she was scheduled for counseling. Upon meeting with the patient, she was clearly upset and was seen mumbling under her breath. When asked if everything is alright, her response was, " I am having shitty day." As this writer and the patient walked down the hall to this writer's office, the patient was heard complaining and using profanity. She was strongly advised to discontinue with her comments in the hallway as it was inappropriate. Then the patient continues to vent until she entered into this writer's office about another staff member; however, her comments were heard, which led to the Clinical Director addressing the matter about the patient's comments being disrespectful and inappropriate in this writer's office.

It was reported the facility admitted a resident requiring insulin injections. Resident Gregory Regosin DOB: 6/4/61 was admitted 30 day ago and was diagnosed with diabetes and diabetic neuropathy. According to the reporting party the facility had been administering the resident's medication due the resident inability to self-administer due to the neuropathy. On 7/21/16 the administrator Maria Manimeo became angry with the resident regarding an unrelated issue and declared "you can give it to you yourself" referring to the insulin. The resident disclosed that the facility is administering the medication (insulin), however at time the facility refuses to administer the injection. The resident stated he is unable to administer in injection due

Also, Mrs. Glynn informed the doctor that he was hurting her and he told her that it was because she wanted to save tooth # 32 which it was just a wisdom tooth. T he following day which it was Saturday, September 17 in our facility in the North, another issued took place with another patient her name is Jimenez Saida was schedule for extraction 16, 18 and 19, but on this day Dr. Sadati only performed extraction on tooth # 18 because while he was extracting this tooth Dr. Sadati yelled to the patient “Open your fucking mouth” this patient speaks English and Spanish and she understood. Furiously Mrs. Jimenez got up from the chair and walked to the front area and complaint about how rude and disrespectful how she was treated by the doctor. In this occasion our dental assistant Dwight was assisting the Dr. and he witness this incident. Both of this patient’s have not come back to our office due to the fact that they were not treated with respect, but I am sure that they would be willing to testify these

According to the American College of Healthcare Administrators Code of Ethics and the AMA, “Physicians have an ethical obligation to report impaired, incompetent, and/or unethical colleagues in accordance with the legal requirements in each state” (American Medical Association, n.d.). In this case, the Chief of the department believes physicians should look out for one another; especially since Dr. Delmonico was well-respected 45 year tenured physician and brings much needed revenue to the facility. However, Dr. Sears has the ethical duty to confidentially and objectively evaluate the reported accusation to assure remedies or to further report to a higher authority (AMA). Administrators and physicians have a common charge to protect patients from disruptive behaviors.

The behavioral and chemical dependency hospital I worked for was 70-bed hospital employed mental health technicians, nurses, social workers and doctors. One day I received a call from one of our mental health technicians who informed me that her colleague is “having an affair” with one of our patients. According to the claim, the night shift mental health technician witnessed what seemed to be a shadow of the technician performing inappropriate sexual acts with the patient. Two of our technicians supposedly witnessed the incident during their night shift. One witness stated that our technician made a comment about being in love with the teenager. After learning of the incident, I tried to reach out to the accused to understand her side; however, I was unable to reach her because she has been calling in sick. I later learned that the patient involved was only 16 years old and our mental health technician was in her early thirties. The sixteen year old patient was released from out hospital shortly after I learned about the incident and some claimed that our mental health technician picked her up and took her in. I reached out to the technician once again to start my investigation and I was successful in setting up a meeting with her. She arrived thirty minutes before and seemed very upset when she came into the office and said “I quit” slamming her hand on my desk and

As a new graduate nurse, I was hired as a floor nurse on the medical surgical unit. I had two months of orientation before I was on my own on the unit. It was a fighting experience for me because I had a full assignment with eight to ten patients during night shifts. My nursing director and colleagues were very supportive during my transition. I had a patient who was abusive to staff with past medical history of IVDU, GERD, Bipolar (untreated), and chronic pain. I felt outside my comfort zone because I was worried about my safety. The patient was labeled as a “difficult patient” on the unit and most nurses refused to have her. One evening, she was complaining of back cramping after a session of physical therapy and received morphine IVP with little effect.. Patient was impulsive, and abusive toward the staff that morning. When I was getting a report from the previous nurse, the patient was getting agitated and left the unit to smoke. The nurse felt that would calm her down and make her less belligerent toward the nursing staff. During my assessment, she reports being extremely nauseous which was not resolved with antiemetic. The patient continues to seem to be in distress, obtain normal vitals and 12-lead EKG. She appears less comfortable, agitated, and her EKG remain normal sinus rhythm. The doctor was at the bedside to evaluate but not concerned. He ordered for another dose of morphine IV with Zofran IV left the unit. He reported he would be back later to check on the patient with the primary team. In addition, he consulted pain services to better manage her chronic pain. The pain was not managed, she remains nauseous and sweating. I needed to approach her with an open mindset and look for an underlying cause of her discomfort. I notify the charge nurse on the

About 2:30 in the afternoon, M.E. was in her patient’s room and J.P. confronted her in front of the respiratory staff and students that were present about why she was/wasn’t doing certain things and what was making her so slow; J.P. caught M.E. off guard and was very abrasive, belittling and verbally abusive; M.E. felt attacked and embarrassed, especially since this behavior took place in front of colleagues. J.P. felt frustrated that M.E. was not more competent and efficient in her care and confronted her about it. After the confrontation, there were no words spoken between the two of them for days and even though months have passed, there is still an obvious tension and unresolved conflict between these two individuals. There is currently a noticeable effort being put forth by both women but the conflict they experienced is not yet fixed.