The Importance Of Transition Of Patient Care

For my seventh clinical shift at the Loma Linda Veterans Affairs Medical Center, my assigned preceptor Filipina Gumangan assigned me three patients on the 4NW unit. The unit where I precept is an intensive care step down unit. Filipina’s objective for giving me three patients this shift was to give me an opportunity to continue exercising my time management skills and to practice my reporting and charting skills, and wound care. This shift I was responsible for many clinical duties corresponding to the care of these patients. My patients this shift were Mr. B, a 72 year-old Vietnam War veteran newly diagnosed with colon cancer, Mr. S, a 65 year-old Vietnam War veteran in the hospital for complicated urinary tract infection, Mr. R, a 90 year-old Korean and Vietnam War veteran. Caring for these patients taught me more about the humanbecoming perspective of nursing and showed me about multidisciplinary coordination with peers, colleagues, and more.

This week I have fully grasp the work that goes into being an RN, case manager and what it entails to fully review a patients’ stay at the hospital in order to discharge them in the most effective and efficient way. I understand the need for these professionals in the healthcare field, not only in the hospital setting, but in skilled nursing facilities as well, one reason being is that I believe someone has to advocate and review the patients’ needs before they are sent home. Just like last week I was able to sit in on rounds and observe a great deal of the doctor and case manager dynamic and how important it is for both to know the patient as much possible. Sitting in rounds every morning makes me realize how hard it is to make decisions for another

Hello everyone. My name is John Smith. I am a RN here at the Hospital and I am the Director of Nursing Informatics. As I’m sure all of you know to be successful in the care of our Patients you have to work as an interdisciplinary team and timely COMMUNICATION is key! As you can see I have capitalized communication to emphasize how important it is. As a Nurse on the unit a big part of communication is reporting a patient’s condition after you have

Transition of care appeals to me the most in my practice as a case manager. When a patient gets admitted, the interdisciplinary team starts working on the discharge planning. I always wonder how can the team know for sure, that the patient is ready to be transitioned and how can we know for sure that the transition of care is safe and it would not be overlook?

I sincerely believe that I accomplished my goals this week. I realized that I served 14 patients by combining the ability of knowledge, my attitude for excellence that I have consistently defeat the odds to become the very best Nurse practitioner; I can become. This clinical experience brings forth many opportunities and achievements. The most important experience this week; I had the ability to identify as primary healthcare provider a high risk need for the patient to be transferred to the Hospital for further evaluation without delay; due to complaints of “leg cold from the knee down to the feet”, which my evaluation was based on evidence practice knowledge of compassion and skill with the autonomy to practice, diagnose, and treat patients

Q by taking vitals right away and report immediately, since the night shift reported elevated blood pressure at the end of their shift. This would help in determining the next step in delegating and treating Ms. Q. If her blood pressure remained elevated, the RN would delegate the LPN/LVN to proceed with the next step. After getting vitals for Ms. Q., the RN would ask the UAP to assist with Mrs. A, because she is scheduled for a Doppler flow study this morning and can help by bringing the machine to the room and by assisting the patient with morning care and ambulation prior to the study being done. The RN could have delegated Ms. Q vitals to the nursing student as well, but since the vitals were extremely high, the RN chose to have an experienced UAP report the vitals within a specific time frame. The RN has delegated these tasks because they are within the UAP’s scope of practice. They are trained to perform certain duties and tasks such as documenting and reporting information, and assisting patients with their activities of daily living. If the RN were to delegate the administration of medication they could possibly give it to the wrong patient and cause adverse reaction. The fluidity of the communication between the UAP and the RN team leader greatly impacts identifying what is expected from the UAP to communicate to the RN. Siegel and Young (2010) explain that the UAP needs clear guidelines and procedures,

Miscommunication and missed information, resulting in potential errors, have been on the rise at Pelham Medical Center. In the past, the primary nursing staff was giving verbal report to oncoming nurses at the nursing stations. There are many disadvantages to this practice. Verbal report at the nursing station is distracting with so many nurses talking at the same time and is frequently interrupted by other staff, call bells, and family members. There are also potential HIPPA violations when reporting on patients within earshot of other people who are not involved in that patient’s care. The patients and their family members or care

Please lift up the staff at Northline we were face with a crisis yesterday with one of patients. The service that we provider to the community is ultimately to change the life of father, sons, mother, daughter and so forth. The selfless service that Northline provide to our patient was remarkable each member of our team display Humanic in action. Please cover our staff in prayer as we cope with the situation.

As the Action List indicates, one of your patients is already enrolled so you should not be consenting her. The Clearinghouse will notify the CMA about this admission providing your contact information.

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

The ED Director, Administration, and Human Resources (HR) were extremely supportive, in addition, there were a few nurses who could comprehend the lack of alternatives and were quietly supportive. This was an extremely emotion and difficult process and the support of HR, the ED Director, and Administration could not have been more pivotal in the moving this project ahead.

Several of the roles which I observed this morning were expected: the nurses took vitals for incoming patients, performed focused assessments, and were the main communicators between family, the patient, and the physician. I realized when the first patient came in around 10:00 am, the RN’s role in assessments, gathering blood work, and carrying out all the necessary steps to situate and stabilize the patient as soon as possible. It was incredible seeing the nurses work together, in sync, in those first moments when the patient was brought in. And though expected, I appreciated seeing just how much communication was held and information was gathered from the patient or family members by the nurse. Jessica asked the right questions from both parties, while still showing incredible empathy and not making the whole situation seem rushed and flustering. I understood this as another essential role of the nurse in the ED; he or she must maintain even in such a fast-paced environment empathy and focus in each interaction.

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During the team formation, a number of challenges manifested. Firstly, it was the fact that there were nurses from other units. Hence, there were fears that they may not be well informed with procedures undertaken in our unit. However, this challenged was effectively addressed by assigning the nurses from other units a nurse from our unit to help her during the emergency period.

Patient HH eligibility and/ or connection with care coordination (adding if phone call was made to CMA);