The applicant is a 49 year old male with two adult children. The applicant has never been married is currently in a relationship with his significant other, Kim for the past 17 years. The applicant currently resides with his 2 sisters and his mother. Also, the applicant is employed as a car sales person with Toyota and is at risk with losing employment due to his drug habits as to why the patient is seeking treatment. The applicant reports that methadone works well for him. Addressing the drug history- The applicant had his first alcohol at the age of 16 and his last use was 3-11 months ago. According to the applicant, he only drinks occasional during celebration of an event. The applicant is willing to discontinue drinking alcohol occasionally as it will interfere with his methadone treatment once if he was to be admitted. Furthermore, the applicant used cocaine at the age of 19, inhalation. The applicant reports that he haven 't used cocaine for a year, prior to his usage, it would have been 1/2 gram. In addition, the applicant then reports at the age of 29, he used heroin and still uses heroin by IV daily. His last use was this morning. Lastly, the applicant first began using marijuana at the age of 16, on/off for 33 years. The patient reports only smoking THC less than once a month, 1-2 blunts.
In regards to case ‘The Court Was Appalled’, I have to agree with the ruling of the court’s decision. The physicians’ obligation to properly examine his patients such as in the case of Tomick’s breast the first time was complete negligence. The physician did not complete a thorough examination, and then the patient had to wait months to be reevaluated again. The Ohio Court of Appeals made the right decision in favoring the patient. If the proper care was given early on the mass size potentially could have been prevented. This patient was not treated with the ethical respectany patient should receive when seeking help/treatment. It is very alarming that a physician whose job is to take care of other humans would disregard giving a proper
The human service field is very extensive, with numerous professions falling under the vast human services umbrella. Human services include all jobs which provide a service to society in times of crisis ("Public health career guide: Human Services," 2015, para. 4). Therefore, the human service field includes workers trained to help people cope with crisis or chronic situations where the person feels they need assistance regaining their personal power and self-sufficiency. Often times the situation the client needs help with are external, such as the loss of a job, the need for food, shelter or for help leaving a dangerous situation. For other clients, the crisis is more internally based, such as a mental health issues, physical health crisis or a disability ("The Definition of Human Services," 2015, para. 1). Ethically, all human service providers should have an understanding of the theories, best practices and current trends in the field. To provide this education sometimes interns or less experienced workers are often required to provide supervisors with a case presentation. This paper is a hypothetical case presentation
This paper will explain the seven principles of patient-clinician communication. It will then apply three of those principles to my interactions with my patients. Next, it will describe three methods being used in my area of practice to improved communication between the patients and clinicians. It will ultimately choose one of those principles that applies best to my practice and clearly describe how I use it. It will describe ethical principles that can be applied to issues with patient-clinician communication. Finally, it will explain the importance of ethics in communication and how patient safety is influenced by good or bad team communication.
D-The patient arrived on time for her session and informed this writer that she has decided to remain with the clinic as she learned on her own that no detox facility will accept her because she is testing negative and currently on methadone. The patient further mentioned that she is questioning as to whether or not her sister and her mother would help her as they said they would; however, the patient had a moment and looked back when her family did not help her as she struggled with her children. Furthermore, the patient reports, her sister did not give her the $80.00 for her rent. The patient reports that she had asked some guy for assistance. This writer addressed with the patient about her employment status and money management. The patient
Pt. is currently in Phase 7 of the tx program. Pt. has been able to maintain abstinence from mood-altering substances, her drug screen results has shown no evidence of ongoing BZP use. During the recent quarter, Pt. has maintained a positive balance in his AMS account. Pt. maintained his full-time employment status and self-reported that he has no issues or concerns with his current financial status. Pt. remains at 130 mg. of Methadone and she reported maintain a satisfactory dosing level. During the last quartet, Pt. learned about heroin use, resentment, powerlessness and treatment progress. Pt. seemed to understand that she was completely without power, without strength, without any ability to control how much she used during her addiction.
This information was reviewed with Dr. Ryan Snyder, P.A. Brent Cook, and Howard McQuirter, LCSW. They shared the disposition that the patient should be discharged pending his agreeing to follow up with outpatient services. Patient has agreed to follow up with outpatient services as recommended. The patient 's family member has been contacted and made aware of the plans concerning the patient. Patient contracted for safety, was given outpatient referral information, and completed a crisis plan;.
Counselor met with Pt. for an arranged individual session. Counselor greeted Pt. and encouraged him to discuss his last tx plan, which he did. Pt. informed this writer that his last day in the program will be Wednesday, 3/23/17. Pt. indicated that he would like to donate his two take home boxes to the program if someone needs them. Counselor encouraged Pt. to assess his current account balance and explain his UDS results where shows a pattern of opiates use. Pt. spoke about how he uses oxycotin sometimes because his elbow retained fluid. Pt. verbalized how he drained his left elbow last week and now has a lot of fluid again. Counselor asked Pt. whether he has used any drugs, which he replied no. Pt. reported that he is using oxycotin for the
The client reported he was born in Caracas, Venezuela and later moved to Spain and then Chili with his parents because of his father work. At 12-years old he moved to Florida where he currently resides in Coconut Creek. He noted he was primarily raised by his biological parents.The client described his childhood as "good, " and could not describe anything negative about his upbringing. He reported he and his family moved every four years due to his father work. However, he described his relationship with his mother as "okay." Per the client his mother was strict and had rules for him to follow. He indicated at times, they would have verbal disagreement and she would punish him by way of spanking or grounding him. When asked about his father, he stated that his father more calmer and always wanted to spend time with him after coming home from a business trip. Nevertheless, the client could not recall anything negative about his relationship with his parents.The client reported he feels closest to his mother because she was there when his father was away for work purposes. The client reported as a juvenile, he experienced being bullied in school. He stated while attending school in Chili, he noted he was
The incomplete record and physician inquiry process are all done through EPIC, Lexington Medical Center’s EHR. As soon as the patient is discharged any quantitative deficiencies are automatically flagged in EPIC which then sends the notice to the physician’s inbox. Physicians are able to correct any deficiencies where ever they have internet access they do not have to be in their office or the hospital. If the deficiency is found by an analyst it must be added manually (see example 11.4). A lot of the doctors will send the deficiency back stating that it is complete, when it really is not; therefor there must be a work queue for any completed deficiencies to be reviewed. Any completed deficiencies are labeled “analysis needed”. After
D-The patient arrived early to her appointment. Indecisive whether or not she wants to increase her methadone dose. The patient stated that she is not getting cravings, only withdrawals. The patient is experiencing hot/cold flashes and sweats. The patient then requested to increase her dose by 5mgs, at which this writer completed the dose change request. During the course of the session, this writer and the patient discussed the patient treatment plan goals as the patient has an upcoming treatment plan for the month of August.
Background information: John Smith is a Caucasian male in his mid-forties residing Truman, AR. Pt reported he has an ongoing struggle with substance abuse addiction since the age of seventeen. Pt was admitted voluntarily to SBBH for suicidal ideation. Also, pt reports he has receive several therapeutic treatments. Recently, the patient reports he quit his job a couple of weeks ago; therefore, he has no source of income. Pt reports he has been arrested about fourteen years ago for possession of drugs. Currently, pt reports he does not have any legal matters. The pt barrier to treatment is substance abuse. John’s strengths include: verbal and use of health care system. His weaknesses consist of abuse of substances and unemployed. Pt’s systems are frustration, stress, hard to fall asleep, sleep disturbances, and irritable. John’s hobbies and interest are fishing and cooking.
Transitions in care, such as admission to and discharge from the hospital, put patients at risk for errors due to poor communication and inadvertent information loss (1–5). One discrepancy does not necessarily mean an error. In fact, most discrepancies are due to adapting chronic medication to the patient’s newly diagnosed condition, or because the examinations and/or interventions performed could interfere with their usual medication. Medication discrepancies, established as unexplained differences among documented drug regimens at the interfaces of care1 (admission, transfer, and discharge) are highly prevalent. Some are intended therapeutic modifications, but others are unintentional and clinically unjustified. Prior studies suggest that
Date 10/27/15: The client was engaged and motivated this session. The client participated in each activity. The session consisted of free play, storyboard activity, and role-playing activity.
Even though I didn’t have enough time to finish the interview, I was able to cover almost everything in HIP and medical history. As I reflect back on the interview session, I felt comfortable during the interview because the SP was very engaged in the conversation. However, I overlooked her expression about the bad phone call she got from her sister. At the time, I interpreted her sadness as being uncomfortable and moved on with the conversation without prying into her personal matter. Thus, my assumption had caused me to miss out the entire psychosocial context that leads the episode of her chest pain. To improve on this area, I should learn to put my personal interpretation and assumption aside and being more proactive in asking the patient to elaborate the story. In addition, I would make sure to