The Patient Who Ll Through the Cracks

In: Other Topics

Submitted By deemo82
Words 3145
Pages 13
Analysis of a Case Study
Community Health Nursing - NUR 311
November 01, 2015

Abstract
This paper examines the role of a home care nurse in the case of a patient who is non-compliant with care and lacks knowledge about his medical condition. Nurses have numerous legal, professional and ethical duties. The three main duties are to respect all patients’ confidentiality and autonomy and to recognize duty of care owed to all patients. This paper will explore the ethical dilemma involved with a patient unwillingness to comply and the nurse’s duty to respect the patient’s wishes. Further discussion will give insight into the nurse’s legal responsibilities and elaborate on the principle of beneficence, health concepts, autonomy vs. paternalism, patient teaching, family as caregiver, Eco mapping, and therapeutic nursing interventions.
Analysis of a Case Study
Situation Overview
The article, “The Patient Who Fell Through The Cracks,” described Mr. H as a 65 years old, morbidly obese man diagnosed with CHF, PVD, bilateral venous stasis ulcers, and HTN. He lived at home with his diabetic wife and mentally-challenged adult son. The environment in which they resided was unhealthy, possibly due to self-care deficit and lack of knowledge about health and wellness. Mr. H. lacked the support system that he needed to care for himself. Due to Mr. H’s inability to comprehend and self-care deficit immediate intervention had to be initiated by the nurse which involved providing wound care and health promotion.

Principle of Beneficence: Rule of utility
Beneficence is the concept of supporting the patient by preventing further harm, yet the nurse has an ethical responsibility to respect the patient’s wishes even if the patient refusal of care could lead to a negative outcome (American Nursing Association, 2010). As nurses, making decisions on an everyday basis requires…...

Similar Documents

Ll Bean Cas

...company towards success and maintained this status through innovation and his progressive attitude within his community. Throughout its history, various critical factors have contributed to the success of L.L. Bean. Leon Leonwood Bean created a strong corporate foundation which has been strategically expanded since his passing. Presently, the company has achieved strong brand equity with an identifiable and relatable heritage that helps retain and maintain existing and prospective customers. Success can be attributed to the company’s core value, which is to treat each customer with respect. For this reason, the company has strived to maintain excellent customer service (i.e. fast and accurate), competitive prices and delivery time. These values have resulted in high customer loyalty and satisfaction, high employee morale, and an overall positive reputation as a provider of high quality products. External or environmental factors have created great opportunities for the company, many of which were projected by and capitalized on through LL Bean’s management team. For example, customer demographic and psychographic (e.g. more women in the workforce and rising age of population) have become major contributing factors to the success of mail-order sales (i.e. L.L. Bean’s primary distribution channel). Just as LL Bean treats its customers “as human beings,” the company also values its employees and generates high morale through various strategies. For example, the......

Words: 1019 - Pages: 5

World War Ll Through the 1970s

...World War II through the 1970s Renita Moody Professor James Adams History 105 June 2, 2013 Americans at first tried to stay out of the war, but this became less feasible as Hitler’s aggression continued. In the United States, the Great Depression had provoked a strong drift toward isolationism. The trend was already manifested in the American rejection of League of Nations following World War I, but during the depression many Americans remained preoccupied by domestic affairs. For more reasons why many Americans resisted involvement in European affairs. Their memories of the First world war made many Americans leery to get involved in European affairs. In 1914, Americans watched as a dizzying series of alliances led one nation into battle with another, without any apparent justification. The brutality of the first World War further made Americans shy away from any involvement in European affairs (Shultz, 2012) The Great Depression was a second reason why Americans favored isolationism before the second World war. The Great Depression deepened this isolationism most Americans were simply to focused on improving life in the United States to advocate getting involved in diplomatic disputes abroad. Respect for Hitler was the third reason why American favored isolationism, Adolf Hitler who had plucked Germany from its own economic depression in record time. By the late 1930s, American icons like the aviator Charles Lindbergh argued......

Words: 1574 - Pages: 7

Crack the Whip

...Crack the whip Recently I don't know if it's just me or not, but I've noticed that everywhere I go there happens to be a child that is throwing a fit, crying or even scream at their parents. Generally it seems to be the subject they're not getting what they want that day at that moment. And it doesn't bother me that it's happening, the thing that bothers me is that parents give in to their child's or children's demand and walks them back into Walmart, Toys R Us, Target or whatever store that I happen to be at that day and them whatever it is that they want. It's kind of sad to see that today's kids lack discipline and that parents don't do anything about it beside turn. Kids today are spoiled and parents are not doing what is necessary to fix. As I said last kids are spoiled, at least kinds where I live are spoiled. I believe it starts with the parents. Parents who don't feel like standing their ground because their kids happen to throw a tantrum, cry, and complain at them. Parents have become pushovers and cave in at the signs that their children might become upset or cause a scene. The parents have I believe gotten lazy when it comes to keeping their kids in line or so self-absorb they care more about their image and how their children are acting. Parent who believe that they can buy their children's affection by giving them everything they want. Are just as bad those parents are just trying to fill a void that they have made with material items saying yes to everything...

Words: 923 - Pages: 4

Crack Cocaine & Mass Incarceration

...The American Crack Epidemic: How the War on Drugs was as Detrimental to Society as Drugs Themselves. Lucas Carneiro U.S. History 4/21/2013 Throughout the mid-20th century, Americans have experimented with illicit drugs, from marijuana to LSD. In the late 70s and early 80s, the high cost of cocaine made it the drug of choice for wealthy, elite, White Americans. On the other side of the social spectrum, lower-class African Americans sought an escape from their difficult circumstances in impoverished inner-city neighborhoods. They found refuge in crack, a smokeable form of cocaine, whose low production cost, high addictiveness, and debilitating nature made it the drug of choice for urban African American communities in 1986 (Reinarman, 1997; Watkins, 1998; Fullilove, 1998). The drug contributed to the increase in disease, violence, and poverty in these communities, turning inner-city neighborhoods into “war zones”. The U.S. Government’s War on Drugs campaign did little to solve this crisis, using aggressive, military tactics to address an epidemic surrounded by socioeconomic and health issues. In the 1960s, the Vietnam conflict among several unpopular moves by the U.S. government created a generation of rebellious, young Americans. This generation experimented with drugs in order to alter their state of mind, and to escape from the problems that came with politics and society. The generation of young “hippies” ignited a drug culture in the U.S. As time progressed,......

Words: 2189 - Pages: 9

Aids Patients

...AIDS PATIENT CARE and STDs Volume 21, Number 5, 2007 © Mary Ann Liebert, Inc. DOI: 10.1089/apc.2006.0105 A Quantitative Study on the Condom-Use Behaviors of Eighteen- to Twenty-Four–Year-Old Urban African American Males STEPHEN B. KENNEDY, M.D., M.P.H.,1 SHERRY NOLEN, A.A.,2 JEFFREY APPLEWHITE,2 ZHENFENG PAN, Ph.D.,1 STEPHEN SHAMBLEN, Ph.D.,1 and KENNETH J. VANDERHOFF, M.A.1 ABSTRACT This research study sought to develop, pilot test, and assess a brief male-centered condom promotion program for urban young adult African American males. For study implementation, both qualitative and quantitative research methods were used, and the project was guided by tenets of two common but integrated theoretical frameworks in HIV/sexually transmitted disease (STD) prevention research: the social cognitive theory and the stages of change model. The purpose of the qualitative component was to identify and explore condom-use barriers and facilitators while that of the quantitative component was to identify the prevalence of condom-related behaviors and the feasibility of program administration. After recruitment of study participants from hang-out spots and street intercepts, study participants were self-administered a baseline survey regarding their perceived condom-use behaviors prior to random assignment to program conditions (a condom promotion program and an attentionmatched comparison condition). In this paper, we report the findings from the analyses of the......

Words: 9505 - Pages: 39

Who Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care Is Safer Care

...WHO Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care is Safer Care a WHO Guidelines on Hand Hygiene in Health Care: a Summary © World Health Organization 2009 WHO/IER/PSP/2009.07 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All......

Words: 27087 - Pages: 109

Ll Bean

...3. LL Bean utilizes a probability distribution methodology to help predict the optimal order size of a specific item. The probability distribution is driven by a series of calculations that will predict forecast errors. One of the major concerns is that LL Bean tends to order more inventory than what was predicted in the frozen forecast. Their logic for doing this is that the cost of understocking exceeds the cost of overstocking. According to Marck Fasold (CFO), this methodology leads to major discrepancies with forecasting the demand for their products. Also, this leads to buyers being challenged that products are being ordered that do not align with their forecasting predictions. In addition, Rol Fessenden eludes to the fact that the methodology has issues because they can’t find any real distribution errors among products and he is not convinced about the estimating contribution margins and liquidation costs. In summary, there are many challenges to LL Bean’s ordering process. LL Bean tends to be okay with just overstocking rather than focusing on making accurate predictions. This approach leads to unwarranted costs that can be eliminated if they focused on refining their ordering process and methodology. Secondly, it seems that buyers make forecasts that are not being applied by the company which turn leads to unsatisfied buyers because they feel their judgments are not being respected. Lastly, LL Bean should allow the distribution forecast errors to be handled by......

Words: 463 - Pages: 2

Kl; Ll

...This brand new exclusive eBook is packed full of proven strategies, techniques and tips to help ensure you give yourself the best chance possible to pass the ITIL Foundation exam first time. With 136 easy to absorb pages you will learn more than 30 step-by-step techniques to help ensure your ITIL Foundation exam success. This really is the ‘missing element’ from your Foundation revision and the perfect compliment to any training notes or study guides you may already have. This eBook contains essential information you need to know about how to pass the ITIL Foundation multiple choice exam. This information has been carefully selected, along with worked examples from the syllabus, to create this unique eBook. Written by a top ITIL Consultant who has proven these techniques time and time again with students he coaches. Across 12 content packed chapters you will learn: • • • • • • • • • • • • • The awesome 3-PASS answering strategy to obtain over 26 points Worked examples of ITIL questions and three mistakes you must avoid making! Exam jargon demystified: Stems, Options, Qualifiers and Modifiers – Revealed How to overcoming the challenges and pitfalls of the ITIL Foundation exam How Examiners actually create questions and the secrets you must know How to verify you have the correct answer and avoid changing your mind The ‘DNA’ of ITIL Foundation questions explained – step-by-step How to effectively boost your memory recall using Flashcards Five ways to ensure you quickly......

Words: 2487 - Pages: 10

Patient Safety Workshop

...Patient Safety Workshop Learning From Error PATIENT SAFETY WORKSHOP LEARNING FROM ERROR WHO Library Cataloguing-in-Publication Data Patient safety workshop: learning from error. Includes CD-ROM 1.Patient care - standards. 2.Medical errors - standards. 3.Patient rights. 4.Health facilities - standards. 5.Health Management and Planning. I.World Health Organization. ISBN 978 92 4 159902 3 (NLM Classification: WX 167) This publication is a reprint of material originally distributed as WHO/IER/PSP/2008.09. © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific......

Words: 9127 - Pages: 37

English Patient

...Clifton, which took place during the 1939 desert expedition in search of Zerzura. “I cannot begin this meeting tonight without referring very sympathetically to those tragic occurrences. “The lecture this evening ...” From the minutes of the Geographical Society meeting of November 194-, London I The Villa SHE STANDS UP in the garden where she has been working and looks into the distance. She has sensed a shift in the weather. There is another gust of wind, a buckle of noise in the air, and the tall cypresses sway. She turns and moves uphill towards the house, climbing over a low wall, feeling the first drops of rain on her bare arms. She crosses the loggia and quickly enters the house. In the kitchen she doesn’t pause but goes through it and climbs the stairs which are in darkness and then continues along the long hall, at the end of which is a wedge of light from an open door. She turns into the room which is another garden—this one made up of trees and bowers painted over its walls and ceiling. The man lies on the bed, his body exposed to the breeze, and he turns his head slowly towards her as she enters. Every four days she washes his black body, beginning at the destroyed feet. She wets a washcloth and holding it above his ankles squeezes the water onto him, looking up as he murmurs, seeing his smile. Above the shins the burns are worst. Beyond purple. Bone. She has nursed him for months and she knows the body well, the penis sleeping like a sea horse,......

Words: 83532 - Pages: 335

Ll Bean

...retail outlets, while customers that purchase products online or through the catalog and select their preferred shipping carrier and delivery times. A very interesting fact is that 90% of the customers choose UPS for their shipping needs. An Interesting Problem Although L.L Bean was on the right track in trying to limit the products that they kept stocked at all times they ended up with an interesting problem. Because of the nature and roots of the company it carries several products that although could be considered seasonal they were often times purchased and needed immediately. For instance a hunter may need a certain piece of equipment and need it shipped right away. This caused a bit of a wave in the forecasting tools that the company had used. Because of this minor issue the company decided that they could still use the forecasting tool and for the most part it would be accurate, however they had to rely on the knowledge of their retail stores and the data collected from online purchases to decide what unusual items they needed to keep in stock. One way that the company decided to counter balance this issue was by ordering supplies in less quantities but more often. This changed the scheme of their warehouse operations but for the better. References: Cook, J. (n.d.). Current Issue: Quarter 2 2015. Retrieved August 2, 2015. About L.L.Bean: Company History. (n.d.). Retrieved August 2, 2015. LL Bean Selects UPS For Deliveries. (2009, February 12).......

Words: 873 - Pages: 4

Improving Patient Health Through Standardized Representations of Health Information

...Healthcare standards are essential to development and implementation of Electronic Medical Record (EMR), Representation of healthcare data in a standard will help in reaching better interoperability. I will track patient admission until discharge with diagnosis of Angina. As a clinician I will diagnose this patient using Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT), the EMR or the coders should then map my diagnosis into international Classification of Diseases Clinical Modification 10th edition (ICD-10- CM)) using the Interactive Map-Assisted Generation of ICD Codes (I-MAGIC) (I-MAGIC], 2015). SNOMED-CT is required in stage 2 and should be used for documenting problem (Levy, 2013a). SNOMED-CT is a comprehensive clinical terminology that describe the diagnosis in details, it is way of description is close to the medical language. SNOMED-CT easy to map to other clinical terminology like ICD-9 and ICD-10 in a addition to LOINC (Giannangelo, 2015)., The SNOMED-CT code for Angina is 194828000, and the ICD-10-CM for Angina is I24.9, Acute ischemic heart disease (NLM, 2013). At admission the physician need to order Electrocardiogram (EKG) test to confirm angina, EKG was ordered and EMR attached the Current Procedural Terminology (CPT), CPT was developed by the American Medical Association (AMA) it doesn’t contain diagnosis codes it only focuses in procedures, the CPT code for EKG 12 leads is 93000 (Giannangelo, 2015; ECG CPT, 2015). The physician placed an......

Words: 716 - Pages: 3

Crack Epidemic

...In 80s and 90s the crack epidemic took over the ghetto world and played a big role in developing hip hop music. Black Americans even sung about it in their songs. Drug dealers distributed crack in black neighborhoods and got them involved into that business. For African Americans it was a way to earn money and get out of ghetto. Especially back then when they were discriminated. So, the crack epidemic and hip hop back in 80s and 90s went hand in hand. It was very interesting to read the "Dark Alliance". I found out a lot of interesting staff of which I didn't know before. Of course, not every black american was involved in drug distribution and consumption. There were the ones who worked hard to pursue their dreams; however, there were more people who consumed and distributed than those who didn't. Rappers raped about it in their songs. The song "White Lines" describes how at parties MC and other party people consumed it. MC also tells us about his feelings and illusions he had. Once, people get involved into the crack epidemic, it is hard to stop. Also in the song, MC tells that every time you want it more and more. So, the dosage increases and money decreases. Some still suffer from the crack epidemic. People who used to party and play cool are now addicts who just think about getting drugs. The Crack Epidemic brought violence and sickness. People on crack are not stable and can think straight. As a consequence they are more violent and uncontrollable. People also become......

Words: 767 - Pages: 4

Crack

...CRACK Should women addicted to crack be able to have children? Barbara Harris says no. Harris has adopted four children from a drug addict. She has also founded CRACK (Children Requiring A Caring Kommunity) a non-profit organization that offers $200 in cash to addicts who agree to be sterilized or undergo long-term contraception like Norplant, which is surgically imbedded under the skin. In this essay I will be discussing what the ethical dilemma is, who the stakeholders are in this ethical dilemma, analyzing the problem by reference to the categorical imperative, analyzing the problem from a Kantian and utilitarian standpoint and giving my overall opinion of this matter. As I understand it the ethical dilemma here is the procedure in itself. Some are saying that the women are doing it for the money to buy more drugs. Also, saying that it takes away women rights to reproduce. Physicians and attorneys are saying that the women are in no condition to consent to being sterilized. They say that because these women are mentally ill and poor they are not capable of making their own decisions. But Barbara Harris from her own experiences says that women addicted to crack do not need to have babies. These women are bringing babies into the world addicted to crack. She tells of a story of how she adopted four children from a crack addicted woman. One of the children would wake up screaming in the middle of the night. She says it looked like his eyes were about to pop out of his......

Words: 1057 - Pages: 5

Health Promotion Through Patient Education

...Health Promotion through Patient Education Marianne Green Grand Canyon University February 25, 2012 Health Promotion through Patient Education “The current care systems cannot do the job. Trying harder will not work. Changing systems of care will” (The National Academies Press, 2010, p. 41). Health care transformation has become a major focus in the United States. Implementing these changes requires a complete overhaul of the current system through changes in approaches, guidelines and direction in patient care. With the increasing amount of elderly entering the health care system, insurance premiums on the rise and health costs increasing contribute to this disparity. Individuals with unhealthy lifestyles such as drug use, alcoholism, and poor eating habits also drive health care costs higher. The meaning of “health promotion” has been defined as helping people to change their lifestyles and enable them to move toward a state of optimal health. In a paper written by the U.S. Public Health Service in 1980, health promotion was set forth as a process that would advocate health and will likely enhance personal (individual, family and community), private (professional and business) and public government(local, state, and federal). The goal is that through support of positive health practices, a societal norm will evolve (Edelman & Mandle, 2009). As each individual goes through life, health promotion serves as a service that helps humans to be able to......

Words: 1035 - Pages: 5