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Chapter 4 summary of health care ethics
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This week I was able to shadow for two days, for a total of sixteen hours. On Wednesday Thursday, and Friday I spent twelve hours researching articles for my journal entry and senior project. During my days of shadowing, it ran almost exactly as it has been for the past three weeks. The day began with meeting D.L. in her office. She would review emails and voicemails for any emergent conditions and handle those properly. Next, she would print off her patient list of her patients that were in the hospital for bedside rounds. Then she would review each of the labs, any test results and notes from the disciplinary team for any problems. On bedside rounds the patients, family or caregiver members were made aware of the care after heart surgery meeting, which is required if the patient is going home after surgery. When the patient’s family/caregiver attends the meeting, it is documented in the chart of the patient. If the patient has had no family/caregiver attendance at the meeting, it is brought to the surgeon’s attention so it can be discussed with the patient and/or family/caregiver who will be taking care of the patient at home.
The rest of each day was spent in the clinic for an assortment of patient appointments. This is how I accounted for my hours this week in order to complete the required time, journal and power point presentation for this class.
This week I was in the role of
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Member of profession. This week I was able to participate in bedside rounds, the care after heart surgery meeting and clinic, which I was able to interact with patients, family/care giver members and the health care team. This week I was able to recruit family/care giver members for the care after heart surgery meeting. This week there were five patient’s family/caregiver members in attendance out of thirteen patients that were going home after discharge. Also, I was also able to attend a meeting with the chief of cardiac surgery. Dr. K., held this meeting to get the opinion of the coordinators about operating the clinic with two doctors and two physician assistants every day. The idea behind this is the clinic will have the ability to see more patients on a daily basis. Another reason is, the doctors and physician assistants will have more time off in the rotation. Dr. K believes operating the clinic this way will promote retention with physicians/physician assistants and improve outcomes for their patients. A concrete decision will be reached in May on whether it is implemented or not. After the meeting, I thought to myself that it is a good idea since retention seems to be an issue with ECHI & Vidant Medical Center. I also believe there will be less wait times for patients to see the providers and if they are having problems they will be able to be worked in a lot quicker to be seen. This week I chose the nursing value Accountability.
I chose this because it is the right, power and competence to act. Again, this week I recruited the patient’s family/care giver to come to class for the care after heart surgery meeting. Taking the initiative to recruit the family/care giver to participate in the meeting makes me feel more involved with this experience. Don’t get me wrong I like observing because you can learn a lot by just listening and watching. However, when involved mentally and physically, I consider it a personal
experience. The article I am going to discuss is The nurse navigator: An evolving model of care. I chose this article based on “The role of nurse navigator has enormous potential for assisting the rapidly growing population with complex and chronic conditions as well as others whom are underserved or experiencing disconnected patterns of care” (McMurray & Cooper, 2016). During my shadowing experience with a nurse navigator, I have seen how they can help provide the best possible outcome with at risk patients who have had a life changing diagnosis. For most people, they need to have someone that they can trust, look to for support and have the answers that they are needed to guide them through their healthcare trek. It has been shown that when a navigator is involved with patient centered care, there is an increase in capability and execution of services with having the capacity to share patient information among the multidisciplinary healthcare team. This is due to having the ability to see a patient’s medical, social, psychological and economic information will help guide the team and patient in making the appropriate healthcare plan for the patient. Having this capability gives the patient a feeling of control and personalized care in order to help make informed decisions about their health care journey. Nurse navigators also have the ability to influence care transition for patients as their ailment or treatment needs change during the course of an acute/chronic disease. A nurse navigator is a liaison between many disciples of the health care system. They help identify resources to health care which helps decrease duplication of care, customizes guidance to specific patients/family needs, provides timely and appropriate care to patients. In my opinion, this article provides a glance about a nurse navigators evolution in the health care industry and the opportunity to fill the gap in care for at risk patients who the health care system makes it challenging to access services. My project focuses on the nurse navigator role. D.L. and I discussed this article. She discussed that since she took on the role of a nurse navigator that the role has expanded to support patients with heart failure, chronic obstructive pulmonary disease and diabetes, just not cancer. She believes that nurse navigators have a unique opportunity to provide a customize service to patients that have been diagnosed with a disease, in care transition between the hospital setting and home, for constantly ailing and other vulnerable patients who are often readmitted within thirty days of treatment for the same illness. Most people are left with inconsistent information from numerous providers; a nurse navigator can help the patient understand the resources necessary for their condition. With this help from the nurse navigator, the overall support gap and coordination of care can decrease the risk of overall illness and demise and decrease the cost for the patient and the health care system. In our discussion D.L. believes as health care continues to grow in complexity and as more burden is placed on hospitals to reduce length of stays and readmissions, the role of a nurse navigator will become more treasured. In my understanding of the effectiveness of the nurse navigator role, the hospital must be able to determine the influence of the navigator on the vulnerable population where process failure can occur. For the vulnerable patients, the hospital must be able to analyze the method and influence of the nurse navigator when the patient first walks through the door, at discharge and when making follow-up appointments to provide the best care transition for the patient. I also believe that based on my research and shadowing experience that the future outlook on this role will grow immensely. This is based on working as a nurse, growing health care cost and health care management. My progress on this class, assignment and project is on track. I will complete this alternate design plan project and all the components within the assigned time frame. I believe that with my shadowing experience and research, I have reached my overall goal of understanding the role of a nurse navigator. This experience was great and I learned so many things about a patient navigator. This week I am planning to work on my senior power point presentation, complete any other required paperwork that needs to be submitted, and post a peer comment on two classmates senior power point presentation. Reference McMurray, A., & Cooper, H. (2017). The nurse navigator: An evolving model of care. Collegian, 24(2), 205-212. doi:10.1016/j.colegn.2016.01.002
Erik Erikson was heavily influenced by Freud but while Freud was an ID psychologist, Erikson was an ego psychologist. Erikson stressed that the development of the ego depended heavily on personal and social aspects. “According to Erikson, the ego develops as it successfully resolves crises that are distinctly social in nature. These involve establishing a sense of trust in others, developing a sense of identity in society, and helping the next generation prepare for the future” (McLeod, S. 1970). His theory focused on personality development through eight distinct stages. He believed that personality progressed in a stacking or pre-determined manner, this is referred to as the epigenetic principle. One must
...ecause it gave me an opportunity to hear the perspective of other health care professionals that are not in the same field as me. I also got to learn what role each health care professional could contribute to the Triple Aim goal. Also, this experience would make it easier for me to work with other professionals during my course of study and after I graduate because I have been a little exposure to what it is going to be like discussing and trying to figure out ways we can contribute to the Triple Aim goal together as a team.
...to communicate with your patient in order for them to be updated with their family’s sickness. And also have compassion towards them. You are likely to see a lot of injuries and scenarios play out among patients that have been admitted to the hospital. There are many achievements in this field that you may accomplish. And priorities that you have to deal with. For instants your time you have to adjust your schedule.
Goal 2- Garner experience and practice in treatment planning and assessments through performing psychosocial and diagnostic assessments; consider methods of interventions appropriate to client presentation; develop treatment plans with supervisor for assigned clients.
My job shadow happened at the Sanford Hospital and I went on a tour with different professions throughout the hospital. Most of my time was spent with Kelly Tollfeson and she works with the business part of the hospital. I visited four different parts of the hospital while on the tour. The job shadow took place on November 30th, 2016, around Thanksgiving.
Over the last few years, I shadowed a Primary Care Adult Nurse Practitioner whose office is located in the underserved urban area of Irvington, NJ. She also takes care of patients from the surrounding areas of Irvington, Newark, and East Orange, all of which have very large underserved populations including African Americans, Latinos, and patients from the Middle East. During my clinical shadowing, I gained a appreciation for the complexity of treating long term chronic conditions such as asthma, diabetes, HIV, and hypertension. In many cases these conditions were exacerbated due to poor nutrition, non-compliance, and lack of education about healthy lifestyle choices. I gained a keen understanding of the importance of patient education and the ability to connect patients with community services to help them with their economic and social challenges.
He was an outpatient, who arrived at 8 am to get ready for his surgery. Feeling I was ecstatic and enthusiastic to get back into the field of work to do my clinical rotations. Although I was ready to have a new experience at the recovery unit, I was also extremely scared, because this unit was a specialized unit, where the patient needs vital care while recovering from anesthesia.
It was becoming increasing clear to me that the hospital environment was a community that I knew one day I wanted to be a part of. For three summers, I shadowed one emergency room physician who has been an amazing role model and mentor. This exposure taught me not only a plethora of terms, but to think critically and quickly and to prioritize and reason in ways that had immediate benefit. I also learned a great deal about bedside manner, and how important it is to be culturally and emotionally sensitive to patients. Like my family, this physician noticed so many important things about people- who they are and what matters to them. She knew just when to touch someone on the shoulder, or to step back. She accounted for age and class and race and subtleties that don’t even have words. She viewed each patient as a whole person. One night a woman was brought into the ER after a car crash and needed a neurological exam immediately. She was wearing a hijab. This physician kindly addressed the woman and asked her if she wanted the door closed while she took off her hijab. They both knew the cultural significance, helping this patient to feel respected and less
My sixteen week class in English 111. I was really nervous about this class. Because English has never been my strong point. This class has hard, but fun all at the same time. I learn a lot from this class. Meanwhile,the first day of class you handed a paper with a question on it. “The first thing I want to say to you who are students is that you must not think of being here to receive an education; instead, you will do much better to think of being here to claim one.” Even though putting my all in what I have learned, claiming my education with hard work because using the skills of the meal plan, as we write to different audiences and learning to be a Critically thinker as I start becoming a critically-Literate Citizenship.
On May 3, 2017, I did my job shadow at the Labor and Delivery department at UCSD Jacobs medical center. For my job shadow, I chose to shadow a perinatal nurse in which I shadowed from 8:00 a.m. to 12 p.m. When I came one of a perinatal nurse gave me a tour of their own floor. I got to know where change, medication room and labor and delivery rooms. What I observed was that perinatal nurse has to check on their patients are going into labor. I got to observe the nurses assigned patients. The nurse would check on the patient's vital signs and the babies. I observed how the nurse would change the IV and drain some of the IV. They also gave me the opportunity to observe a c-section. During the c-section, there was a lot of cutting and getting the
Seven months into my job they called a code Blue in Vascular Interventional Radiology and according to procedure I ran over with all the equipment, drugs, and fluids necessary, but nothing would have gotten me ready for what was going to happen. Once I arrived, without hesitation, I went to the anesthesiologist in charge to see how I could help, but noticed that nothing could be done so instead I put on my gloves and proceeded to fall in line for CPR compressions. During hectic situations it is important to keep communication open; thus, I told the nurses ahead of me to let me go since I was a fresh pair of strong hands. From the age of three up to this point I had always wanted to be a doctor and follow in my grandfather’s footsteps; I always said with an optimistic imagination and convocation at hand that no one would ever die on my operating table. As I was doing compressions I remember glancing over to the frantic look on the patient’s family and the pale, emotionless and lifeless face of the person below my hands.
As a result, I always felt that I am actively participating in patients’ care. She allowed me to perform patient examinations most of the time and encouraged me to build up a good rapport with the patients. I think my past experience and medical knowledge was helped me lot during the history taking because I was able to go through history taking in a systematic manner and at the same time I could think of possible differential diagnosis. Furthermore, working in a medical clinic as a physician assistant also helped me a lot because one of the responsibilities delegated to me is taking patients history, however, this time it was different that I had to work out and actively think about a possible cause for patient concerns. The weakness I observe during history taking was sometimes I am little quick that might hurt the doctor-patient relationship, So, I am planning to improve my listening skill with less interruption to patients, I believe that might help the patient to express their concerns freely. Also, I am determined to listen to patients concerns in a non- judgemental manner to get the unbiased clinical
Shadowing in autopsies satisfied my early high school curiosity in that I was able to understand the anatomy of the human body. Knowing the appearance of a normal organ helped me to recognize when an organ was abnormal whether that was through weight or appearance. I have learned that the human body encapsulates teachable knowledge and evidence that leads to the diagnosing of disease and corresponding treatment. My time spent shadowing in autopsies confirmed my interest in learning more about the field of medicine and the doctor’s role in direct patient care. I have shadowed Dr. Simmons, a cardiology specialist and Dr. Fitzhugh at the NIH sickle cell department. In cardiology, I witnessed the physician’s role in patient education regarding
It requires a great deal of strength, not only physically but emotionally as well. There is a great deal of physical work involved, such as lifting patients and equipment. You are on your feet most of of the day, and there is little patience for idle hands. Patients will often require much patience, and excellent people skills are a must. There will also be situations that will pull on the heart strings, however, we are there to do a job, and to do it to the greatest of our ability. Yes, I was aware of most of these requirements, but I don’t believe that I understood them to the fullest detail, and I probably won’t, unless I experience them first-hand. Fortunately, now, I have been educated on expecting such circumstances, and will be better equipped to handle them when such situations
In this “Digital Age” that we currently live in, it becomes very easy for an individual to become infatuated with the amount of social media outlets available on the internet. Platforms like Facebook, Twitter, Instagram, and Snapchat all revolve around the idea of showcasing one’s personal life for the sake of receiving positive feedback or attention by peers and strangers from the outside world. An episode of the Netflix sci-fi anthology series, “Black Mirror,” decides to tackle this topic in a surreal yet imaginative way. The episode in particular, “Nosedive,” investigates a hypothetical future or alternate universe where social media profiles and star ratings have become the norm. The plot revolves around a young lady named Lacie, who