Appendix Q Caring practice-M Dort 3-24-18.docx

Appendix Q Caring practice-M Dort 3-24-18.docx - APPENDIX Q...

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A PPENDIX Q - TEMPLATE FOR CARING PRACTICE EXEMPLAR WORKSHEET ( NC III ) (Meets requirements for Caring Practices Competency: CP III b) ______________________________________________________________________________ Caring Practice Exemplar Worksheet (Provide an exemplar of your practice demonstrating caring practice. Reference the essential indicators, Harris Health NPPM Care Delivery components and caring practice documents (reviewed for CP III a) illustrated in the exemplar. Be prepared to identify patient, if necessary Fill in the form below. Place cursor in box to begin typing or choose your response using the drop-down boxes, as appropriate. Form must be TYPEWRITTEN. Ensure you answer or respond to the question completely. Consideration will be given to quality of writing skills [e.g., spelling, punctuation, coherency, etc.]) Name: Marie Dort Date: 2/12/2018 Document Exemplar: I provided care to a newly diagnosed 56-year-old African American male patient with metastatic pancreatic adenocarcinoma. He had multiple comorbidities (e.g. HTN, DM II, and prostatic hypertrophy) as well as metastases to the spine, pelvis, and femur which caused a great deal of pain. His pain was exacerbated by walking and I had just been informed by the unit clerk that the patient had rang his call bell stating that nothing was being done to manage his pain. I took a deep breath before entering the patient’s room and carefully considered what could be done to support the patient’s physical, emotional, and spiritual needs during our interaction. I introduced myself and asked if I could speak with him about his pain. To provide privacy, I closed the curtain. I sat in a chair near him and listened carefully as he described the onset, character, duration, and intensity of his pain. I maintained eye contact and nodded in acknowledgement as he explained his feelings. He explained that the pain limited his ability to care for himself. He described how strong he had once been, how he had always gone to work every day, and how he did not like to take medications unless it was absolutely necessary. I maintained a positive attitude and refrained from judgement. As I listened, I touched his hand. Tears came down his cheeks, and he said, “I’m in pain, real pain and the Morphine is not helping.” Earlier I had tried comfort measures, including a gentle massage to his back. I also encouraged the patient to relax and to use deep breathing. I dimmed the lights to help create a calm peaceful environment and suggested that he listen to soft music and prayer. As I sat with the patient, I explained his pain regimen using clear, simple language. I discussed the treatment plan as well as the frequency of his pain medications. I was soon able to see that the medications only relieved his pain for a short period of time and that adjustments needed to be made for better pain control. The next step was to collaborate with his physician team.
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Using SBAR, I communicated with the primary team and repeated the patient’s concerns.
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