We allowed her sister to stay with her after a

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comfortable to pass in peace. We allowed her sister to stay with her after a negative COVID swab due to the terminal illness and impending death. The sister got to spend 48 hours with her sister and seeing her peacefully without pain for the last 36 hours of that time. We as nurses must always put our patients first and advocate for them when they have no voice. Week Six: Health Disparities: Week six posed some challenges for me as COVID-19 has surged in Oklahoma. This week I was able to perform more community-related experiences. I worked with our Interim
9 Director of Case Management, George, helping an Elder Native American from our community obtain a refill of her home oxygen. I answered a phone call, and this community member was in tears as she was out of her home oxygen and felt short of breath. She called her oxygen company, and they were out of oxygen as well. Living in rural areas can be both a blessing and a curse. We are further of urban regions and larger companies. Most of our citizens live within the poverty level, and being the only Indian Health Facility within 100 miles, I feel we must put in a little more effort to help our people. Interprofessional Collaboration: George and I could get this Elder her home oxygen by working with Case Management and making multiple calls to oxygen companies. But in the interim, we were able to supply her with a portable oxygen tank until the company could make it to her home with her refill. This was also a moral and ethical decision because someone else may have just told the Elder that we don’t supply oxygen and not tried to figure out what she needed. I also participated in the Quarterly Utilization Review Committee. Patient length of stays, insurance denials, observation vs. inpatient admits, and proper paperwork and documentation were reviewed and discussed. A plan was created for adequately obtaining the MOON, and IMM forms for Medicare admitted patients. Population Health Concerns: I am fortunate to have contacts within the Oklahoma State Department of Health (OSDH) and our local county Health Department. I volunteered to help with Seminole County Health Departments' drive through the COVID-19 vaccination clinic on Friday. I was the second booth passed, and my job was to explain hand hygiene and mask compliance. I handed out hand sanitizer supplied by OSDH.
10 Leadership & Economics: I attended and participated in our monthly Quality Review Committee Meeting, collaborating with all department supervisors. I presented ER throughput times, the number of patients left against medical advice, and patients who left without being seen. I presented quality measures for pain assessments both before and after pain medication administration and the effectiveness of the pain control method. I explained to our team the total number of patients admitted to the hospital and the total number of patients transferred from ER and Med/Surg departments.

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