You are caring for an elderly diabetic patient. She was admitted for DKA, and has a long history of elevated A1c’s
Today we are going to talk about collaboration. This is very important to get patients the care they need. It is easy in the hospital because everyone is accessible and under the same roof. You do have to collaborate in other settings as well. It may not be as easy to do this, however.
I am going to discuss a patient who was admitted to homecare who had a history of chronic heart failure and diabetes. She was repeatedly hospitalized and discharged to home to manage her illness. We were admitting her on homecare because of her recently hospitalization for uncontrolled blood sugars and DKA (diabetic ketoacidosis). She was treated for that and released home.
We went in to assist her in regaining her strength and managing her blood sugars after the hospital stay. In this scenario, you will be the first person to see her. You are the admitting homecare nurse. As the admission nurse. As the case manager, it is your job to develop a plan of care for this patient. You will think of what services would best serve her and obtain a doctor’s order for them.
So in this scenario, I want you to think about what services this patient who is frequently hospitalized for the same issues would need. She is frequently hospitalized for diabetes mismanagement. She has suffered consequences, such as poor vision, difficulty managing medications, weakness, and being tired. She fatigues easily and cannot do her normal activities.
What services do you think would benefit her? What types of collaboration would be used in her care in this setting?
[Please understand homecare. Remember to think about this patient’s needs and support your choices with your resources. Think about the disease process, the needs that she has based on the information I provided, and what are priorities to help her be safe.]
The concept of collaboration includes the exemplars of conflict resolution, case management, and interdisciplinary teams.
For this discussion I have a few scenarios that you may choose from. Scenario 1:
You are a charge nurse and one of your responsibilities is to make nursing assignments. It has been a very busy day with many admissions and discharges on your unit. You are notified from the OR that your unit must admit another patient. Only one nurse does not have a full team. This nurse has been very busy with discharges during her shift, and when you approach her about taking another patient she yells at you “why are you picking on me? Can’t you see I’ve been busy all day? Why don’t you take the admit?” What do you do?
She has developed a pressure ulcer on her left heel during her stay in the hospital and is having a hard time walking to the bathroom now. The doctor is planning on discharging your patient in 3 days. The patient does have family close by, but they have not been involved in her health care to this point. What do you do? What plans for collaboration should you make?
You are working in the ICU and are caring for a patient who was involved in a MVA. He has multiple injuries including broken bones and a TBI. His family is very anxious about the injuries, especially the TBI. What can you do to support the family? What resources might you anticipate this family needing? What referrals might you make at this time?
Don’t forget to use scholastic resources to support your discussions and responses. Also remember to use APA formatting.