Summary: At The Mayo Clinic

Day 2 (OB) – Vaginal Birth and preparation for birth. Hanging Pitocin, and Lactated Ringers, and being able to watch an epidural insertion.

Spinal cord injury is a sudden and devastating event for patients. The injury can be extremely debilitating and it may require a significant alteration in lifestyle post injury. P.R. has sustained a relatively high level (C6) spinal cord injury, which makes him very limited functional capacity. He will go through grieving process followed by anger for the loss of function and independence. This may be especially difficult for P.R. because he is a young man in his thirties who sustained a debilitating injury in a foreign country without any support from family and friends. Spinal cord injury has left P.R. unable to move his entire lower extremities and trunk muscles. He is unable to do the most basic activities, such as feeding and bowel movement without the help of a caregiver. For a young man who was active and completely independent, it is very difficult to accept this reality. It should also be noted that most of the nursing staff are females, which further damages his male ego for having total dependence.

In my last year’s placement I had the privilege of Interning at the Veteran’s Affairs in the Spinal Cord Injury clinic. In the SCI clinic I worked closely with Veterans who had experienced spinal cord injury, which resulted in permanent paralyses such as paraplegia or quadriplegia. Ms. Cynthia Jackson was one of my clients that had an enormous impact on me. Ms. Jackson is 55 year old African American. Ms. Jackson served in the United Air force in the late 1970’s post-Vietnam War and was based in Germany. While serving in Air force, Ms. Jackson severely injured her back in tanker truck accident which resulted in paralysis in her lower exterminates. Ms. Jackson is wheelchair bond due to her paraplegia, client was referred to the SCI clinic for case management and counseling services.

Similarly, during my previous internship at the BAC article 31 clinic, and because of my veteran status, often times I was asked by my field supervisor, who is also the agency program director, to tap into VA resources to gather additional resources that could be useful for the agency in response to working with veteran clients who are receiving treatment in the BAC agency (Bridging Access to Care). In the context of the use informal structure within the BAC article 31 clinic, I also believe that the efforts put forth in developing and building a relationship with the agency program director, to include contact relationships within the VA institution in support of additional services for veteran clients; exemplify practice forms of informal

Shriner’s Hospital for Children provides services and care to pediatric patients with orthopedic, burns, spinal cord injuries and other concerns in an ambulatory setting. And, I had the opportunity to observe how specialized care was delivered to pediatric patients and how the team prioritize and collaborate the individualized to each patient.

After researching about paraplegic and quadriplegic, it has been determined how they occur and in what parts of the body they affect. According to John Hopkins Medical, if a person suffers with paraplegic or quadriplegic, it is caused by damage to the spinal cord. To determine whether a person has a spinal injury, doctors will use clinical signs to help determine the severity of the injury. When the spinal cord has been injured, the patient might feel pain, and some disorders; such as motor or sensory. When this occurs, it allows the doctor to determine the cause of the injury, however; most spinal injuries are caused by traumatic accidents. The two

Imagine a four year old child, whose physicians believed would never walk or talk, walking into a rehabilitation center unaided for the very first time. With wide smiles and tear filled eyes, therapists and staff stop to stare with awe and pride, because they have watched this small girl struggle to accomplish this milestone for years. Unfortunately, this outcome may not be typical; however this has happened at Mercy Rehabilitation. Here dedicated therapists work to give patients the skills needed to return to living life as they were able before an accident or injury, and help children living with special needs reach their full potential. To patients seeking rehabilitation services,

The Center for Disease Report (CDC) for Mortality and Morbidity Weekly has reported falls as being the leading cause of injury among the elderly adult. According to stats released by the CDC, there are an estimated one to three falls that occur among the elderly resulting in a direct medical cost of $30 billion yearly. According to Barbour et al. (2012) falls often result in significant consequences for the elderly adult patients including, hip fracture, brain injuries, limited functional abilities, and reductions in physical activities. Barbour et al. further reported that falls are more commonly seen in an older adults with some form of arthritis condition that results in poor neuromuscular functioning. Falls, as reported by Barbour et al. states that the incidence of falls within the fifty United States was highest among adult with arthritis condition as compared to a person without arthritis.

Formative evaluations have been very beneficial for me in pre-clinic. During the start of pre-clinic, I did not realize how unsure I would be when it came to handling instruments when working in my classmates’ mouths. The formative evaluations help me to be a little more at ease as the instructors guide me into the right direction. The formative evaluations have enabled me to improve in all areas we have learned thus far in pre-clinic.

Spinal cord injury is a serious problem that effects close to 250,000 people in the United States with 10,000 people being injured per year . There are many things that can lead to spinal cord injury, including athletic injuries, car accidents, and recreational activities like swimming and biking. It primarily effects those between the ages of 16 and 30 and drastically effects the rest of their lives. It is a very debilitating injury that requires extensive medical care, often leaves the patients in a great deal of pain for the rest of their lives(2), and the treatment of which costs $10 billion dollars a year in the US.(facts from site 1) With all of these factors spurring research on there is a strong drive to

Ben Watson is in his early 20’s with a Bachelor’s in Architecture. Watson decided to go on a rock climbing trip with friends before his graduation. Unfortunately, a day that was supposed to be a day with friends, it became a day that would change his life upside down. Watson fell 500 feet from where he was rock climbing. Although he doesn’t remember much he does recall doctors telling him he had an incomplete spinal cord injury and as a result, he won’t have any movement in his legs.

Why would a world-renowned organization, Mayo Clinic, already know for quality embark on a quality improvement journey?

One challenge I was faced with while on CE I, was while working with a patient she was talking badly about one of the receptionist. The patient calling the receptionist incompetent, since the receptionist had messed up the patient’s appointment time for the second time in two weeks. I was put in an uncomfortable position because I did not want to be rude to the patient, but also did not want to be apart of the patient talking badly about my coworker.

Riverside Clinic has workedas a family clinic with one rheumatologist, eight physicians, two nurses, and 6 office staff since 2002 and covered a population of 6800 of residents in the riverside community in Calgary, AB. The current workflow in clinic is on paper-based system and due to increasing the covered population and the necessity of better communication between the health care provider in the clinic, management of the clinic decided to improve overall quality of care in a practice, convert a medical practice based on paper records to an electronic health record and practice management software package. The previous record system was paper charts and for giving better health care services to patients, it should be changed with new health

A review of the literature regarding spinal immobilisation has been undertaken using databases for PubMed, MEDLINE, CINAHL, OVID and Cochrane EBM. Reviews were electronically searched using the subject headings “spinal injuries”, “spinal immobilisation” and “management of spinal injuries”. The results generated by the search were limited to English language articles and reviewed for relevance to the topic. The aim of this literature review is to compare and contrast the views on spinal immobilisation and to achieve a better knowledge of evidence based practice.