See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.
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Please send a blank e-mail to: clinicalnursingcases-subscribe@topica.comSummary: Breast Cancer is a well-defined and treatable if not always curable disease process. Once suspicious findings-lumps, nodules, nipple discharge or other telltale signs of a problem are noted-prompt evaluation and follow-up care is essential. In this case, a patient with a family history of breast cancer presented with a "mass" and was evaluated. She did not follow-up as directed and when she later died of breast cancer, her estate would sue for "failure to diagnose, treat."
The 22-year-old woman was seen at a family planning clinic. Part of the assessment/examination included a routine breast exam. The nurse palpated a mass in the woman's left breast.
"The detection of a lump in the breast is a common occurrence. Although most lumps are not caused by cancer, the possibility of malignancy must always be considered. Thus, from the moment a lump or a suspicious change in texture or resistance is felt in some part of the breast, a series of decisions must be taken to exclude or establish the diagnosis of cancer."2
A family history revealed that the patient's mother had died of breast cancer.
"A cancerous tumor of breast tissue, the most common cancer in women and the second leading cause of cancer death for women in the World. The rate increases between 30 to 50 years of age and reaches a second peak at 65 years of age. Risk factors include a family history of breast cancer, no children, exposure to radiation, young age when menstruation began, late menopause, being overweight, diabetes, high blood pressure, long-term cystic disease of the breast, and, possibly, hormone therapy after menopause. Women who are over 40 years of age when they bear their first child and patients with cancer in other areas also have a greater risk of getting breast cancer."3
The nurse referred her to a nearby breast clinic for evaluation of the suspicious lump. Both a nurse and physician would verify the presence of the finding.
"Beginning symptoms, found in most cases by self-examination, include a small painless lump, thick or dimpled skin, or nipple withdrawal. As the tumor grows there may be a nipple discharge, pain, ulcers, and swollen lymph glands under the arms. The diagnosis is made by a careful physical examination, a breast scan (mammography), and examination of tumor cells."3
The patient was instructed to return in three months for evaluation and follow-up of the suspicious mass. Given the family history and nature of the lump, the patient was instructed that the likelihood of malignancy was high.
The suspicious findings and instructions for the patient to follow-up were communicated to the patient. They were also documented in the patient's chart carefully. It was emphasized that the finding needed to be monitored in light of the patient's family history. Despite this instruction, the woman did not return in three months as directed.
No further evaluation would be documented until two years later when a formal diagnosis of Breast Cancer was made. In addition to the cancer in the breast, metastasis to the neck and arm was noted.
"Tumors are more common in the left than in the right breast and in the upper and outer parts of the breast. Spreading through the lymph system to lymph nodes under the arm (axillary) and to bone, lung, brain, and liver is common. Surgical treatment, depending on the tumor, may be a radical, modified radical or simple removal of the breast (mastectomy), with the removal of axillary nodes."3
A radical mastectomy was performed and followed by standard chemotherapy/radiation treatment. The cancer did not respond to the therapy. The patient, initially suspected of having disease at 22, would die at 25.
Due to patient's lack of follow-up, treatment of the disease was potentially delayed for two crucial years.
"The best chance for successful treatment occurs when cancer is found early. Mammograms, or special x-rays of the breast, can detect more than 90 percent of all cancers and should be part of every woman's breast health program, along with breast self-exam and physical exam by a doctor. If a cancer is found early, it is more than 90 percent likely to be completely curable."3
Following her death, the patient's estate filed a lawsuit against the Family Planning Clinic and the Breast Center nurses & physicians. The suit alleged negligence and medical malpractice in the treatment/diagnosis of the patient's Breast Cancer.
Noting the circumstances of the case, summary judgement was initially handed down in favor of the defendants by the court. It noted that acceptable Nursing/Medical Standards and Procedure had been followed in the assessment, documentation and instruction of the patient with a potential Breast Cancer diagnosis.
The administrator of the patient's estate appealed.
Questions to be answered:
1. Was either the Nursing or Medical staff at either the Family Planning Clinic or Breast Center negligent in their examination or duty to inform the patient of her potential diagnosis?
2. Was prompt and early recognition/treatment of the patient's cancer delayed or hindered by the actions of the nurses or physicians?
3. Was the patient's "failure to follow-up as instructed" responsible for the unmonitored progression of the disease and resulting metastasis?
The court noted that clearly, the woman's potential condition had been identified appropriately. The patient had been informed that she was at high risk for Breast Cancer and that further evaluation was needed. She was made aware of the findings and what they could represent.
No claim of "failure to treat appropriately" could be substantiated.
The court recognized that no treatment had in fact been given by the Family Planning facility or the Breast Clinic. The reason no treatment had been given was strictly due to the patient's failure to comply with stated instructions for follow-up.
The documentation of the early suspicious findings and recommended follow-up instructions were clearly noted in the chart. Noted as well was the fact that the woman did not comply as instructed.
When the cancer was finally detected and treated, it was known that the cancer had spread. At that point the removal of the cancerous breast by itself would not offer a cure.
"If I do get breast cancer, a mastectomy gives me my best shot at survival.
A woman may make the psychological leap of assuming "the more I suffer, the more I deserve to be cured" -- a natural reaction to a frightening disease. Natural but misguided. "Women don't die of this disease because it comes back in the breast, but because of a spread to the bones or liver." "If the cancer hasn't spread before surgery, a mastectomy and breast-preserving lumpectomy, followed by a course of radiation treatments offer the same outcome. And if it has already spread, you need other treatment to cure the distant metastasis."3
The appellate court affirmed the judgement of the lower court.
This case illustrates how crucial early detection and follow-up care of suspicious Breast findings are. It shows also how frivolous lawsuits can be brought against nurses and physicians literally "at will." At no point in the case was there clear evidence of negligence or wrongdoing.
The records show that the initial examination was done quite well. The patient received excellent assessment/guidance when the pre-cancerous findings were initially detected. As a reward for their attention to detail and assessment, the nurses and physicians were dragged into a lawsuit and appeals process.
Despite it's poor chances of success and lack of a case, the administrator of the estate, seeking any type of reward chose to bring the suit. Even after the complaint was initially dismissed, the plaintiff chose to appeal.
For each of the nurses and physicians involved, legal costs needed to be paid and time was lost from employment to attend the depositions, trials and legal proceedings. The fortunate ones among them would have costs covered by malpractice insurance policies.
Commonly, a lawsuit is initiated after an employee has left the facility for another job. An employer in this case is under no obligation to provide legal counsel.
Related Links Sections:
Breast Cancer, Cancer Oncology & Malignancy, Direct Patient Care on: The Nurse Friendly: http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...
Breast Self Examinations, BSEs, Cancer, Oncology & Malignancy on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...
Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation...Courtroom Directory:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/courtrooms....Direct Patient Care Links on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htmEthics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htmMandatory Overtime, Nursing Quality of Patient Care, Short Staffing on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/mandatory.overtime.nur...
Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htmNursing Shortages, Short Staffing on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/nursing.shortages.short.staffing.htmOncology (Cancer) Nurses on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directory/spec/oncology.htmlRadical Mastectomy, Cancer Oncology & Malignancy on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...
Related Nursing Malpractice Cases:September 5, 1999: Sealed "Rape Kit" Reopened By Nurse. Evidence Inadmissible?
Documentation of observations and findings are basic to nursing practice. Our practice is governed by standards of practice and "protocols" to be followed. In this case, a nurse admitting a rape victim collected and placed in a "rape kit" DNA samples, evidence to be submitted for laboratory analysis. The evidence submission protocol would inadvertently be broken by the nurse. The defense for the rapist would argue this breach made the evidence inadmissible.
State v. Southern, 980 P.2d 3 - MT (1999)
http://www.nursefriendly.com/nursing/clinical.cases/090599.htmAugust 29, 1999: Surgeon "Loses Clamp" Behind Patient's Heart During Bypass.
Nurse's Responsibility To Pick Up?
Summary: During any surgical operation, there is an inherent "duty" owed to the patient that the operation will be carried out competently. This includes carrying out specified procedures and taking measures to prevent "foreign" objects from being left in the body cavity. In this case, during a coronary artery bypass grafting, a clamp slipped from the surgeon's sight. It would be found on x-ray later sitting behind the patient's heart.
http://www.nursefriendly.com/nursing/clinical.cases/082999.htmAugust 22, 1999: Psychiatric Nurse, Sued By Hospital After Developing Relationship With Client?
Wright v. Mercy Hosp. Of Janesville - 557 N.W. 2d 846 - WI (1996)
Summary: Doctors and Nurses by nature of their positions deal with patients when they are vulnerable, off-balance and emotionally needy. When the population includes the psychiatric patient, the potential exists for a client to develop "feelings" for the caregiver. In this case, a sexually abused mother of three was admitted for multiple mental disturbances. During the course of the treatment, a relationship developed and led to sexual encounters following discharge. When it came to light, the patient successfully sued. The hospital would attempt to recover damages against the nurse following her testimony in defense of the facility. This is commonly called a Subrogation action.
http://www.nursefriendly.com/nursing/clinical.cases/082299.htmAugust 15, 1999: Violent Psychiatric Patient Attacks Nurse, No Legal Recourse Against Facility or Psychiatrist?
Charleston v. Larson, 696 N.E. 2d 793 - IL 1998
Summary: It would seem absurd, that if a physician admits and facility assigns a nurse to care for a known violent patient, that it has no legal obligation to protect that nurse against violence. In this case, a psychiatric patient sought admission to facility. On admission, he threatened to attack a nurse. When the patient would follow through on his threat, the nurse was denied legal recourse against the psychiatrist who could have taken precautions against the attack
http://www.nursefriendly.com/nursing/clinical.cases/081599.htmAugust 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 -ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htmAugust 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or Quality Of Care.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080199.htmJuly 18, 1999: Good Samaritan Laws & Acts. Do They Cover Nurses Volunteering Nursing Care When A Citizen Goes Anaphylactic.
"Off-duty" healthcare professionals rendering Emergency aid are in most cases "covered" by the Good Samaritan Acts. These are laws enacted in each state that provide some degree of immunity from liability for good faith efforts in giving emergency care. In this case, a nurse and physician were sued for providing assistance in a volunteer function at a "first-aid" station. Good Samaritan "immunity" was not recognized by the courts.
Boccasile v. Cajun Music Ltd. 694 A 2d 686 - RI (1997)
http://www.nursefriendly.com/nursing/clinical.cases/071899.htmJuly 11, 1999: Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue?
Nursing homes are frequently a patient's destination for rehabilitation following surgery. Common conditions fitting this bill include large bone fractures, hip replacements and stroke. Following these acute episodes, the patients are too unstable to go home and not "sick" enough to have their hospital stays reimbursed by insurance companies. The purpose of admission to a nursing home is to help the patient regain lost function, strength and health. In this case, the patient would remain in the Nursing Home till her death of complications. Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm
Sources:1. 40 RRNL 4 (September 1999)
2. Canadian Medical Association. 1998. Clinical Practice Guidelines For The Care And Treatment Of Breast Cancer. Retrieved October 24, 1999 from the World Wide Web. http://www.cma.ca/cmaj/vol-158/issue-3/breastcpg/0003.htm
3. Homeopathy Clinic. No Date given. Breast Cancer: Retrieved October 24, 1999 from the World Wide Web. http://www.homoeopathyclinic.com/
The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/101099.htmSend comments and mail to Andrew Lopez, RN Created on October 24, 1999
Last updated by Andrew Lopez, RN on Monday, January 25, 2010
Sunday, November 21, 2010
Nursing Malpractice Alleged When Suspected Breast Cancer Patient Doesn't Follow Up
Friday, November 19, 2010
Psychiatric Nurse "Misses" Festering Wound Infection? Is She Held To The Same Standard?
See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety: Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.
For a free subscription to our publication:
Please send a blank e-mail to: clinicalnursingcases-subscribe@topica.com
Summary: Registered Nurses in their training cover each of the accepted areas that a new graduate might be expected to work in. Once in the field, it is expected that additional and specific training to a Department or Specialty will be obtained. In this case, the Psychiatric nurses did not pick up on a festering infection in a patient that had tried to commit suicide. Was the fact that they were Psychiatric nurses a valid excuse?The patient was admitted to the facility after he had tried to commit suicide. He had taken a loaded gun, covered his abdomen with a pillow and shot himself. Emergency Medical Services were summoned and the patient was transported to a nearby Emergency Department.
"Suicide Facts:
• Over 32,000 people in the United States kill themselves every year accounting for 1.4% of all deaths, suicide is the 9th leading cause of death in the U.S..
• A person commits suicide about every 15 minutes in the U.S. but it is estimated that an attempt is made about once a minute.
• 60% of all people who commit suicide kill themselves with firearms.
• There are 4 male suicides for every female one however, at least twice as many females as males attempt suicide.
• 3/4 of all suicides are committed by white males."2The patient was examined and stabilized. After Assessment by the Emergency Department physician, a consult with a surgeon was ordered.
His condition was considered serious and transfer to the Intensive Care Unit was performed.
The ICU surgeon arrived and examined the patient's wound. It was clearly a wound into the abdomen with portions of the pillow "stuffing" imbedded inside the body.
No surgical intervention was performed at that time for the patient's self-inflicted gunshot wound. From the date of admission till discharge from the Psychiatric Unit, the patient would receive only a single dose of Intravenous Antibiotics.
During the patient's stay, signs/symptoms of an active infection were noted from the gunshot wound. It is unclear if this was brought to the attention of the physician. It was not documented by the Nursing staff.
What is clear, is that on discharge, the patient was seen by his family physician and was immediately put on antibiotics to treat an active abdominal infection.
Later at home, the patient and his wife had "removed" pieces of the pillow still intact in the patient's wound from the time of the gunshot wound.
A surgeon would again be consulted and a series of three operations to debreed and remove foreign bodies from the patient's abdomen followed.
The surgeon stated plainly, that all of the material present could have been removed when the patient was seen in the hospital initially.
The delay in treatment of the patient's injury clearly had led to both an active infection and the need for further debreeding. The surgeon stated also that further operations still may be required for the wound to heal properly.
The question would arise of "why wasn't the patient treated when initially seen."
The patient sued the hospital, the nursing staff and the physicians who had initially treated him in the hospital. An Emergency Department Physician witness for the plaintiff offered testimony as to standards of care to be observed in this case. The defense moved to have his testimony disallowed.
Questions to be answered:
1. Was the standard of care for a patient admitted for a gunshot wound breached by either the hospital staff, nurses or physicians during the patient's admission.
2. Was either the physician, psychiatrist or nursing staff negligent in their diagnosis/observation of a potentially life threatening infection during the patient's hospital stay in the Psychiatric Unit?
3. Did the documented delay in treatment cause harm to come to the patient and necessitate further medical treatment/attention.
The Emergency Department Physician in his testimony stated clearly that foreign material present in a gunshot wound presented an imminent danger of infection and sepsis. He questioned why it had not been removed initially.In his discussion of the medical and nursing care in the Psychiatric Unit, he made the following observations.
The sole order written to address a potential infection was a single dose of IV antibiotics.
During the stay the wife and patient noted purulent drainage and foreign material still intact in the wound. They claimed to have brought this to the attention of the Nursing staff. Examination of the charting and documentation in the Nurses Notes revealed no such observation.
A medical chart including nurses notes have long been recognized as legal records. The fact that the patient's abdominal wound was not mentioned in the documentation, strongly reinforced the argument that negligent nursing care had been rendered. This omission of observation demonstrated a significant breach of applicable Nursing Standards.
It should be noted that the lack of thorough documentation of the patient's wound by the nurse significantly strengthened the plaintiff's case. Often testimony by "witnesses" can be dismissed or invalidated by an opposing attorney. Clear and concise documentation in a medical chart by a nursing professional, when available, carries much more weight.
The patient's infection was likewise not addressed in the physicians or psychiatrists progress notes.
"When an injured patient seeks legal advice about filing a medical malpractice lawsuit, the attorney's first task is to review the medical records. The attorney is looking for specific acts of negligence and at the overall quality of the record. The strongest medical malpractice lawsuits are based on well-documented, specific acts of negligence. In most cases, however, the negligence is inferred from documented and undocumented events."3
The observation of the patient and duty to report any actual or potential change in condition is a basic nursing standard. The prudent nurse, that is a nurse in any department or specialty with experience similar to the psychiatric nurses in this case, at the first sign of a potential infection of an open wound, would be expected to notify the physician. The next logical step would be to obtain an order to culture the purulent material to identify the organism and it's susceptibilities.
An argument was made and dismissed that because the nurses caring for the patient were not Medical Surgical, Emergency or nurses experienced in Wound Care that their potential liability should be lessened.
It is clearly defined the in nurse practice acts of each state that a licensed "nurse" will be competent to perform certain basic duties. This is regardless of where or under what specialty that nurse is practicing in. Failure to perform these duties will be grounds for disciplinary action against a nurse's privilege to hold a license.
The duty to the patient of observation, accurate charting and documentation, and duty to report to a phsyician (or psychiatrist in this case) significant changes in condition was breached.
The consequences of the delay in treatment were apparent and documented well by the patient's family physician and surgeon performing the three sucessive surgeries.
The main question raised by the defense was the "appropriateness" of a Emergency Physician documenting on the performance of duties of another physician, the surgeon and the nursing staff.
It was ruled that as an Emergency Physician, familiar with standards of care in the Emergency Department, he could give satisfactory testimony on the alleged negligence of both the Medical and Nursing staff.
He stated unequivocally that the patient should not have left the Emergency Room or Intensive Care Unit until arrangements had been made for surgical intervention to treat the patient's gunshot wound and remove the clearly evident foreign bodies.
The simple fact that the patient's condition went untreated both initially and well into his admission merited a finding of negligence on the part of each party involved in the patient's stay.
Related Nursing Link Sections:
Abuse: Domestic, Physical, Verbal Links, Direct Patient Care on: The Nurse Friendly
http://www.nursefriendly.com/nursing/directpatientcare/abuse.htmClinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation...Courtroom Directory:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/courtrooms....Direct Patient Care Links on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htmEthics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htmMedical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htmPhysical and Mechanical Restraints, Direct Patient Care Links on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/physical.mechanical.re...Psychiatric Nurses:
http://www.nursefriendly.com/nursing/directory/spec/psych.htmlPsychiatric Links, Direct Patient Care on: The Nurse Friendly
http://www.nursefriendly.com/nursing/directpatientcare/psychiatric.htmSuicide, Psychiatric & Mental Health, Direct Patient Care on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/psychiatric/suicide.htmViolence & Violent Patients:
http://www.nursefriendly.com/nursing/directpatientcare/violence.violent.patie...Related Nursing Malpractice Cases:
August 22, 1999: Psychiatric Nurse, Sued By hospital After Developing Relationship With Client?
Wright v. Mercy Hosp. Of Janesville - 557 N.W. 2d 846 - WI (1996)
Summary: Doctors and Nurses by nature of their positions deal with patients when they are vulnerable, off-balance and emotionally needy. When the population includes the psychiatric patient, the potential exists for a client to develop "feelings" for the caregiver. In this case, a sexually abused mother of three was admitted for multiple mental disturbances. During the course of the treatment, a relationship developed and led to sexual encounters following discharge. When it came to light, the patient successfully sued. The hospital would attempt to recover damages against the nurse following her testimony in defense of the facility. This is commonly called a Subrogation action.
http://www.nursefriendly.com/nursing/clinical.cases/082299.htmAugust 15, 1999: Violent Psychiatric Patient Attacks Nurse,
No Legal Recourse Against Facility or Psychiatrist?
Charleston v. Larson, 696 N.E. 2d 793 – IL 1998
Summary: It would seem absurd, that if a physician admits and facility assigns a nurse to care for a known violent patient, that it has no legal obligation to protect that nurse against violence. In this case, a psychiatric patient sought admission to facility. On admission, he threatened to attack a nurse. When the patient would follow through on his threat, the nurse was denied legal recourse against the psychiatrist who could have taken precautions against the attack.
http://www.nursefriendly.com/nursing/clinical.cases/081599.htmAugust 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or Quality Of Care.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).July 4, 1999: Diabetic Coronary Artery Bypass Patient, Septic & Noncompliant. Nursing Duty and Responsibility Questioned.
Patient noncompliance can present serious challenges to nurses and physicians providing care. If aware of the proper measures to be taken, what happens when the patient does not agree or comply with the course of treatment? In this case, a patient after having a coronary artery bypass grafting developed a sternal infection. When advised by a nurse to return for treatment, the patient refused.
Kind v. State Ex Rel. Dept. of Health, 728 S.o. 2d 1027 -LA (1999).
http://www.nursefriendly.com/nursing/clinical.cases/070499.htmJune 27, 1999: Elderly Patient Repeatedly Injured In Nursing Home "Accidents." Negligence, Coincidence or Abuse?
As the elderly population continues to increase, more and more families are faced with the decision to place loved ones in nursing homes. When a family member is placed in a facility, a certain standard of care is expected. In this case, a resident was injured repeatedly while under their care. When the patient died a few days after being "dropped" the family sued.
Brickey v. Concerned Care of Midwest Ince. 988 S.W. 2d 592 MO (1999)
http://www.nursefriendly.com/nursing/clinical.cases/062799.htmJune 6, 1999: Emergency Department Nurse Verbally Abused, Physician History Well Documented
Official tolerance for verbal abuse and sexual harassment is approaching zero. It is clear that both are still prevalent in healthcare settings today. Enforcing and reporting instances of abuse are critical to an end being put to the situation. In this case, a physician had a "history" of verbal abuse in the facility involved. It was the documentation of previous events that made formal action and administration of a suspension feasible.
http://www.nursefriendly.com/nursing/clinical.cases/060699.htm
Gordon v. Lewiston Hospital, 714 A.2d 539 – PA (1998)May 30, 1999: Patient Left Unrestrained, Patient Injured. Nurses Judgement Call
The decision to use or not use restraints must be made with caution and good judgement. Their intended purpose must be to protect either the patient or others who may be injured by the patient including the staff caring for the client. The ultimate determination of necessity is left with the physician. Often, the moment to moment necessity is determined by the nurse. In this case a nurse did not feel restraining the patient was necessary. When an injury occurred, the patient sued.
Gerard v. Sacred Heart Medical Center - 937 P. 2d 1104 (1997)Sources:
1. 40 RRNL 5 (October 1999)
2. American Foundation for Suicide Prevention. 1996. Suicide Facts. Retrieved October 24, 1999 from the World Wide Web: http://www.afsp.org/suicide/facts.html
3. Richards, Edward P. Medical Records as a Plaintiff's Weapon. Retrieved June 13, 1999 from the World Wide Web: http://plague.law.umkc.edu/Xfiles/x188.htm
The Uniform Resource Locator (URL) or Internet Street Address of this page is
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Laughter May Be the Best Medicine - ABC News
On staff at New York's esteemed Memorial Sloan-Kettering Cancer Center is Dr. Stubbs the Clown, aka Michael Christensen, co-founder of the Big Apple Circus Clown Care Unit. Since 1986, he's spearheaded a program that has placed 93 clowns in 17 hospitals around the country, making 200,000 bedside calls a year.
Allison Crane, a nurse from Illinois, furthered the effort in 1987, founding the Association for Applied Therapeutic Humor. She had earlier belonged to a focus group called Nurses for Laughter and wanted to expand the program so that all health-care professionals could realize the healing benefits of humor.
Among the AATH's missions is to compile research, and among the most promising studies comes out of Loma Linda University in California, where doctors have been studying laughter's benefits on the immune system.
A 2000 study of 52 male medical students found that when they watched humorous videos, their stress levels, as measured by T-cell activity in the blood, tended to rise, according to Dr. Lee Berk. T-cells, also called "natural killer cells," jump-start the body's immune system by attacking viruses.
In another study, Berk followed two groups of cardiac patients through a yearlong rehabilitation program. All the patents received standard care. But one group also watched 30 minutes of comic videos each day. Berk found that laughter decreased disease-related symptoms, such as arrhythmias.
"It's more than a little ironic that we're quickly realizing just how important humor is to the healing process, because doctors have always had the reputation of being the most humorless of people," said Dr. Greg LeGana, who maintains a duel career in medicine and show business.
LeGana and fellow doctor Barry Levy, a school chum from New York's Cornell Medical College, created the New York cabaret show "Damaged Care," a musical comedy about the medical profession. They've performed before health-care professionals and general audiences throughout the country.
"Anyone who's ever made people laugh knows that they are soothing a soul," said LeGana. "It's great that research seems to be bearing out something we've always known in are hearts to be true."
For more information on the Association for Applied and Therapeutic Laughter, click here.
To learn more about the World Laughter Tour, click here.
--
Any questions, please drop me a line.
******************************************************
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******************************************************
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
150,000 + Nurse-Reviewed & Approved Nursing Links
http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
Bronchitis, Acute, Chronic, Respiratory, Pulmonary Conditions of the Lung, Legal Nursing Consultants, Medical/Legal Consulting
Bronchitis, Emedicine.com:"Acute bronchitis refers simply to inflammation of the tracheobronchial tree. The cause is usually infectious, but allergens and irritants can produce a similar clinical picture. Bronchitis typically occurs in the setting of an upper respiratory illness; thus, it is observed more frequently in the winter months. Asthma can be mistakenly diagnosed as acute bronchitis if the patient has no prior history of asthma. In one study, one third of patients who had been determined to have recurrent bouts of acute bronchitis were eventually identified as having asthma."
- Associations (American Association of Legal Nurse Consultants (AALNC) and others)
- Contact A Legal Nurse Consultant, Nursing Expert
- Legal Nurse Consultant Schools, Nurse Paralegal Programs
- Listserv Discussion Groups, Legal Nurse Consultant Resources
- Medical and Legal Resources
- Nurse Paralegals
- What Exactly Is A Legal Nursing Consultant?
Emedicine.com Main Office
1004 Farnam Street, Suite 300 Omaha, Nebraska 68102
Office: 402-341-3222 Fax: 402-341-3336
edit@eMedicine.com
http://www.emedicine.com/emerg/TOPIC69.HTM******************************************************
Bronchitis Overview, emedicinehealth.com:"Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the trachea (windpipe) and the large and small bronchi (airways) within the lungs become inflamed because of infection or other causes. The thin mucous lining of these airways can become irritated and swollen. The cells that make up this lining may leak fluids in response to the inflammation."
http://www.emedicinehealth.com/bronchitis/article_em.htm******************************************************
Bronchitis, What Causes Bronchitis? The Nemours Foundation:"Acute bronchitis is usually caused by viruses, and it may occur together with or following a cold or other respiratory infection. Germs such as viruses can be spread from person to person by coughing. They can also be spread if you touch your mouth, nose, or eyes after coming into contact with respiratory fluids from an infected person. Smoking (even for a brief time) and being around tobacco smoke, chemical fumes, and other air pollutants for long periods of time puts a person at risk for developing chronic bronchitis."
http://www.kidshealth.com/teen/infections/common/bronchitis.html******************************************************
Bronchitis, Signs and symptoms, mayoclinic.com:"A cough that brings up yellowish-gray or green mucus (sputum) is one of the main signs of bronchitis. Mucus itself isn't abnormal — your airways normally produce up to several tablespoons of mucus secretions every day. But these secretions usually don't accumulate, because they're continuously cleared into your throat and swallowed with your saliva. When the main air passageways in your lungs (bronchial tubes) are inflamed, they often produce large amounts of discolored mucus that comes up when you cough. If this persists for more than three months, it is referred to as chronic bronchitis. Mucus that isn't white or clear usually means there's a secondary infection."
Mayo Clinic
200 First St. S.W.
Rochester, MN 55905
Contact by E-mail
http://www.mayoclinic.com/health/bronchitis/DS00031/DSECTION=2******************************************************
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Nursing Topics, A to Z: A, B, C, D, E, F, G, H, I, K L, M, N, O, P, R, S, T, U, V, W, X, Y, Z
If your website is not listed here, we encourage you to submit it: Add Your Website/URL.
See also:
Nursing Degrees, LPN-RN, RN-BSN, RN-MSN, Online/Offline College, University and more!:"Higher income. Career mobility. Now, no matter where you live or what your schedule, you can earn your Associate or Bachelor Degree to take your professional life to the next level — without putting the rest of your life on hold!"
If you do any Browsing or Windowshopping online, please visit our online Mall:
http://www.nursefriendly.com/shopping/Gifts For Nurses:
http://www.nursefriendly.com/gifts/4nursinguniforms.com:"Choose from Top Nursing Uniform Companies. All sizes, styles and popular name brands available. Large selection of accessories as well: Accessories Blood Pressure Cuffs, Sphygnomanometers Nursing Tote Bags, Carry-Ons, Medical Bags Clinical, Medical Supplies, Nurses Discount Outlet: Angels, Books, Clothing , Equipment, Figurines, Holidays, Home Decor, Jewelry, Nurses, Office Decor, Scrubs, Shoes, T-Shirts Footwear, Shoes, Sandals, Discount, Bargains Gifts For Nurses (Nurses Week) Hosiery, Socks, Stockings Hats, Jackets, Jumpers Jewelry, Earrings, Necklaces, Watches Luxury Spas, Facials, Manicures, Pedicures Perfumes, Fragrances, Phermones Shoes, Boots, Sandals, Footwear, High Heels, Slippers Stethescopes, Nurse Kits, Replacement Parts Swimwear (Tan-Through) Women's Lingerie "
4nursinguniforms.comNurses' Station:"The idea for the Nurses' Station Catalog was conceived in 1989. After searching the marketplace in response to customer inquiries, it became obvious that there were no catalogs of this type serving the nursing profession. To be sure, there were several catalogs offering nurse's uniforms and a smattering of professional items. But there weren't any catalogs at the time offering a range of gifts, clothing, professional items, name badges, shoes and scrubs for nurses. It took two years of hard work to gather samples and put a together a catalog of the most unique and high-quality items for nurses."
Nurses Station P.O. Box 388 Centerbrook, CT 06409-03881
http://www.nursefriendly.com/station/Choose Nursing Uniforms, Shoes, Scrubs, Accessories By Brand:
Accessories Nursing Carry-Ons, Medical Bags, Clinical, Medical Supplies, Footwear, Shoes, Sandals, Discount, Bargains Gifts For Nurses (Nurses Week) Hats, Jackets, Jumpers Jewelry, Earrings, Necklaces, Watches Luxury Spas, Facials, Manicures, Pedicures Perfumes, Fragrances, Phermones Shoes, Boots, Sandals, Footwear, High Heels, Slippers Stethescopes, Nurse Kits, Replacement Parts Swimwear (Tan-Through) Women's Lingerie Surprised? eBay Has Nursing Supplies, scrubs, uniforms, stethescopes, etc.:"You can find nursing supplies right here! With over 5 million items for sale every day, you'll find the nursing supplies you're looking for at the world's online marketplace - eBay!"
http://www.nursefriendly.com/ebay/Nursing In The Media, truthaboutnursing.org
- ER:"Media products under your influence, particularly the NBC/Warner drama "ER," are harming the profession of 2.7 million American nurses by giving the public an inaccurate and inadequate account of what nurses really do to save and improve lives. Research suggests that "ER" strongly and negatively influences the way children view nursing. These products contribute to the nursing shortage, a public health crisis that threatens millions worldwide."
http://www.truthaboutnursing.org/letters/er/
- House, MD:"The main patient in tonight's episode of Fox's House was a nurse who believed that a cat tended to sit with those who were about to die--including, recently, the nurse herself. That may not sound like a promising vehicle for House to improve its abysmal portrayal of nursing. But the show actually presents the nurse as someone with health knowledge. And her search for meaning in faith, for some reason in tragic events, is a real counterpoint to House's cold rationality. Indeed, despite the obvious potential for mockery in the cat angle, the mighty House treats the nurse with considerable respect--he seems to care what she thinks, or at least to find her views unnerving. Of course, the nurse plays no real clinical role in the episode, and no other nurses do either. So the episode suggests, as usual, that physicians provide all important care in hospital settings, including all meaningful psychosocial and physical care. Still, any suggestion that intelligent life resides in a nurse is a welcome departure for House (and for the episode's writer Peter Blake, who also penned a November 2005 House episode that was notable for its physician glorification and its casual contempt for other health professions). Tonight's episode, "Here Kitty," drew 13.1 million U.S. viewers. more... see the relevant film clips... and please join our letter writing campaign!"
http://www.truthaboutnursing.org/letters/house/
- Private Practice:"ABC's Private Practice, whose season ends tomorrow, April 30, may be the only broadcast network show with a major nurse character to return next season. In the February 5 episode (Mike Ostrowski's "Acceptance," 13 million U.S. viewers), lone nurse character Dell Parker, who is studying to be a midwife, shows some tentative clinical aptitude and knowledge to go with his boyish eagerness. Under the close supervision of OB/GYN Addison Montgomery, Dell ably performs a vacuum-assisted delivery. Later he haltingly guides the baby's parents toward breastfeeding. Dell also performs an assured solo ultrasound of pregnant psychiatrist Violet Turner, calming her panic attack and eliciting her agreement to his own suggestion that, though he's "not a doctor," he will likely become a "pretty good midwife." The show still condescends to Dell, who is also the office manager/receptionist at the LA clinic where the show is set. In the March 26 episode (Craig Turk's "Do the Right Thing," 10.1 million U.S. viewers),"
http://www.truthaboutnursing.org/letters/pp/
- "Scrubs" defines nursing:""Scrubs" defines nursing: it's all about shutting up and following physician "orders. " Tonight's episode of NBC's "Scrubs," which purports to teach nurse Carla Espinosa that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse prime time television episodes the Center has ever seen. more..."
http://www.truthaboutnursing.org/news/2009/may/06_scrubs.htmlTo subscribe to our:
Nurse Friendly Notes Newsletter:
Send a blank e-mail to: nursefriendlynotes-subscribe@topica.com
http://www.nursefriendly.comNursing Jokes, Medical Humor, Jokes to make you laugh and smile all day.
Send a blank email to: nursingjokes-subscribe@topica.com
http://lists.topica.com/lists/nursingjokes/Clinical Nursing Cases:
Send a blank message to: clinicalnursingcases-subscribe@topica.com
http://www.nursingcasestudy.comInspirational Stories:
Send a blank e-mail to: inspirationalstories-subscribe@topica.com
http://www.inspirationalnursing.com
Nursing Chat, Nurse Discussion Forums:
http://nursingdiscussions.com
Alphabetical Nursing Topic Discussion, Chat List
******************************************************
- Are good CNA jobs that hard to find?
- Being A Male Nurse
- Curtailing Workplace Gossip
- Dealing With Confrontation In Nursing
- Degree Vs Diploma
- EKG Classes
- First Year On The Floor
- Horror Stories -- working short staffed
- How Many Hours A Week Do You Work
- Impaired Nurses
- Liability Question for Experienced Nurses
- LPN vs. RN vs. BSN, etc...
- Male Nurses
- Mandatory BSN to practice nursing being considered
- Mean Age of RNs
- Military Nursing
- More Foreign Nurses, Is It A Plot?
- Nurse Entrepreneurs
- Nurses Aides, Can't Live With Them. . .
- Nurses In Recovery:
- Nursing & Adult ADD
- Put Male Nurses In Panties
- Rude Doctors
- Specialty Nursing
- Staff Nurses
- Tattoos In The Workplace
- The Nursing Shortage, Your Opinions
- To Stay In Nursing or Not
- Travel Nurses Talk Travel Nursing
- Workplace Violence, Horizontal Violence Against Nurses
Commonly (Frequently) Used Drugs Medication Indexes:
http://www.prescriptionforviagra.com
******************************************************
- Ace Inhibitors (Hypertension)
- AIDS/HIV Acquired Immune Deficiency Syndrome, Human Immunodficiency Virus, Antiviral Agents
- Anti Angiogenesis (Chemotherapy)
- Antibiotics
- Allergy Relief, Antihistamines, Decongestants, Sinus Congestion, Runny Nose, Prescription Drugs, Medications
- Anti-Coagulants, Blood Thinners
- Anti-depressants
- Anxiety Medications
- Appetite Enhancers, Appetite Stimulants, Appetite Stimulation
- Antibiotics
- Anticoagulants, Blood Thinners, Drug Therapy
- Antiviral Agents, HIV, AIDS, Acquired Immune Deficiency Syndrome, Human Immunodficiency Virus
- Appetite Control, Obesity, Weight Loss, Diet Pills
- Appetite Supressants, Diet Pills, Weight Loss, Weight Control
- Barbiturates, Hypnotics, Sedatives
- Benzodiazepines
- Birth Control Pills, Contraception, Drug & Medication Indexes
- Blood Thinners, Anticoagulants, Drug Therapy
- Calcium channel blockers
- Chemo, Antineoplastics, Chemotherapy, Anticancer, Oncology, Prescription Drugs, Medications
- Cardiac, Coronary, Heart Drugs, Medications
- Cholesterol Lowering Drugs, Anti Hyper Lipidemics, Prescription Drugs, Medications
- Contraception, Birth Control Pills, Drug & Medication Indexes
- Controlled Substances, Narcotic Analgesics, Opiates, Opioids,
- Convulsions, Convulsants, Epilepsy, Epileptics, Seizures
- Diet Pills, Weight Loss, Obesity, Appetite Control
- Fluoroquinolones (Antibiotics)
- Gastrointestinal, GI, Ulcers, Heartburn, GERD, Indigestion Prevention Prescription Drugs, Medications
- Hair Loss, Mens Health, Impotence, Obesity, Smoking Cessation
- Hypnotics, Sedatives, Barbiturates
- Impotence, Hair Loss, Mens Health, Obesity, Smoking Cessation
- Laxatives, Physic, Cathartics
- Mens Health, Hair Loss, Impotence, Obesity, Smoking Cessation
- Muscle Relaxants, Centrally Acting
- Narcotic Analgesics, Controlled Substances, Opiates, Opioids,
- Nonsteroidal Anti-Inflammatories, NSAIDS
- Obesity, Weight Loss, Appetite Control, Diet Pills
- Opiates, Opioids, Controlled Substances, Narcotic Analgesics
- Over The Counter (OTC) Medications
- Pain Killers
- Sedatives, Hypnotics, Barbiturates
- Skeletal Muscle Relaxants, Centrally Acting
- Steroids, Anabolic, Corticosteroids, Prednisone
- Smoking Cessation, Impotence, Hair Loss, Mens Health, Obesity
- Respiratory (Asthma, COPD, Emphysema, Pulmonary)
- Weight Gain
- Weight Loss, Obesity, Appetite Control, Diet Pills
******************************************************
--
Any questions, please drop me a line.
******************************************************
Follow us on:
Blogger:
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Twitter!
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******************************************************
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
150,000 + Nurse-Reviewed & Approved Nursing Links
http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
Make-A-Wish Foundation : About Us
Welcome to Wish.org, the online home of the nation’s largest wish-granting organization. Since 1980, the Make-A-Wish Foundation® has given hope, strength and joy to children with life-threatening medical conditions. From our humble beginnings with one boy’s wish to be a police officer, we’ve evolved into an organization that grants a child’s wish in the U.S. every 40 minutes.
--
Any questions, please drop me a line.
******************************************************
Follow us on:
Facebook:
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Nursing Entrepreneurs, Nurses In Business
http://nursingentrepreneurs.ning.com/
Twitter!
http://www.nursefriendly.com/twitter
StumbleUpon,
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******************************************************
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
150,000 + Nurse-Reviewed & Approved Nursing Links
http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
When We Share, Caring For Others, Sharing Our Hopes, Fears, Feelings
When we share laughter, there’s twice the fun;
When we share success, we’ve surpassed what we’ve done.
When we share problems, there’s half the pain;
When we share tears, a rainbow follows rain.
When we share dreams, they become more real;
When we share secrets, it’s our hearts we reveal.
If we share a smile, that’s when our love shows;
If we share a hug, that’s when our love grows.
If we share with someone on whom we depend,
that person is always family or friend.
And what draws us closer and makes us all care,
Is not what we have, but the things we share.Author unknown
--
Any questions, please drop me a line.
******************************************************
Follow us on:
Facebook:
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http://nursingentrepreneurs.ning.com/
Twitter!
http://www.nursefriendly.com/twitter
StumbleUpon,
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******************************************************
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
150,000 + Nurse-Reviewed & Approved Nursing Links
http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
Thursday, November 18, 2010
Schizophrenia, Schizophrenics, Paranoid, Paranoia, Treatments, Symptoms, Psychiatric Mental Health Resources, 4Nursing.com, Nursing & Healthcare Resources
About Schizophrenia.com:"Started in 1995, Schizophrenia.com is a leading web community dedicated to providing high quality information, support and education to the family members, caregivers and individuals who's lives have been impacted by schizophrenia. The site is managed by a group of about 10 independent volunteers around the world - all of whom are either family members (with sons & daughters, brothers and sisters, or parents who have suffered from schizophrenia) or people who have schizophrenia. While none of us are mental health professionals, we are very familiar with the disease both through direct personal experience and extensive reading on the topic. We rely upon what we believe are good sources of scientifically accurate materials relating to schizophrenia and frequently consult with an ever growing group of schizophrenia researchers who act as unofficial advisors to the site - these schizophrenia researchers who help on an unofficial basis by answering our questions and occasionally providing feedback on different areas of the site."
The Tides Center Workteam1, (Schizophrenia.com)
PO Box 29907
San Francisco, CA 94129
szwebmaster@yahoo.com
http://www.schizophrenia.com/******************************************************
Schizophrenia in Children, American Academy of Child and Adolescent Psychiatry (AACAP):"Schizophrenia is a medical illness that causes strange thinking, strange feelings, and unusual behavior. It is an uncommon psychiatric illness in children and is hard to recognize in its early phases. The behavior of children and adolescents with schizophrenia may differ from that of adults with this illness. Child and adolescent psychiatrists look for several of the following early warning signs in youngsters with schizophrenia: seeing things and hearing voices which are not real (hallucinations), odd and eccentric behavior, and/or speech, unusual or bizarre thoughts and ideas, confusing television and dreams from reality."
American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Ave., N.W., Washington, D.C. 20016-3007
voice: 202-966-7300 fax: 202-966-2891
http://www.aacap.org/publications/factsfam/schizo.htm******************************************************
Schizophrenia, Associated Problems in Prepsychotic or Postpsychotic Phase, Internet Mental Health:"Reckless or Impulsive Behavior Obsessive Thinking or Compulsive Rituals Prolonged Anxiety, Tension or Worry Fidgeting, Pacing, or Hyperactivity Sad or Depressed Mood Irritability or Hostility Feeling Worthless or Guilty Fatigue (Physically Tired All Day) Poor Concentration or Attention Sleeping Problem Appetite or Eating Problem Poor Sexual Interest or Ability Overly Dependent Behavior Poor Physical Health."
editor@mentalhealth.com
http://www.mentalhealth.com/dis/p20-ps01.html******************************************************
Schizophrenia & Psychosis, Mental Help Net:"Schizophrenia is a mental disorder that severely impacts how 2.5 million Americans think, feel, and act. It is a disorder that makes it difficult for a person to tell the difference between real and imagined experiences, to think logically, to express normal emotional responses or to behave appropriately in social situations. Schizophrenia can be draining on both the person with schizophrenia and their families. People with schizophrenia often have difficulty functioning in society, at work and in school. Family members may have to help out financially and make sure that medication is taken as prescribed."
Mental Help Net A service of CenterSite, LLC
570 Metro Place Dublin, OH 43017
http://mentalhelp.net/poc/center_index.php?id=7******************************************************
Schizophrenia, Mental Wellness.com, Janssen Pharmaceutica Products:"Schizophrenia is a severe mental illness described by the American Psychiatric Association as "one of the most debilitating and baffling mental illnesses known." The mental disorder is characterized by a dysfunction of the thinking process, such as hallucinations and delusions, and withdrawal from the outside world. Years of research have shown that schizophrenia is a biologically based brain disease. The most recent advances in brain imaging have confirmed imbalances of two brain chemicals – dopamine and serotonin – in those who suffer from schizophrenia. Dopamine is responsible for emotions and motivation; serotonin acts as a messenger and stimulates muscle movement, switching nerves on and off. The brains of people with schizophrenia have elevated dopamine and serotonin activity."
Janssen Pharmaceutica Products, L.P 1-800-JANSSEN (526-7736) http://www.mentalwellness.com/schizophrenia/about/schizophrenia.jsp******************************************************
NARSAD: National Alliance for Research On Schizophrenia and Depression:"NARSAD is a private, not-for-profit public charity 501(C)(3) organized for the purpose of raising and distributing funds for scientific research into the causes, cures, treatments and prevention of severe psychiatric brain disorders, such as schizophrenia and depression."
NARSAD
60 Cutter Mill Road, Suite 404 Great Neck, New York 11021 USA
Main Line: 516 829-0091
Research Grants Program: 516 829-5576 FAX: 516 487-6930
(800) 829-8289 or e-mail info@narsad.org
http://www.narsad.org/******************************************************
Rethink (formerly The National Schizophrenia Fellowship):"Rethink is the largest severe mental illness charity in the UK. As of 2nd July 2002 'Rethink' is the new operating name for 'The National Schizophrenia Fellowship'. We are dedicated to improving the lives of everyone affected by severe mental illness, whether they have a condition themselves, care for others who do, or are professionals or volunteers working in the mental health field. With more than 30 years of experience, and over 1800 staff, Rethink provide a wide range of community services including employment projects, supported housing, day services, helplines, residential care, and respite centres. All our services try to help people take more control of their own lives by building their confidence and strengthening their skills. With nearly 400 services, we support around 5000 people every day."
Rethink, Head Office
30 Tabernacle Street London EC2A 4DD
Tel: 020 7330 9100/01 Fax: 020 7330 9102
National Advice Line Tel: 020 8974 6814 (open 10am to 3pm, Monday to Friday)
email info@rethink.org
http://www.rethink.org/******************************************************
Schizophrenia, Schizophrenia Society of Canada:"• Is a treatable biochemical brain disorder • Strikes 1 in 100 people • Manifests itself usually between the ages of 15 to 25 years • Causes 40% of people with schizophrenia to attempt suicide of which 10% complete the act. • Costs Canadian taxpayers an estimated $4 billion annually in direct and indirect costs It is NOT: The fault of the person or their family. Founded in 1979, the Schizophrenia Society of Canada (SSC) is a national registered charity. SSC works with 10 provincial societies and their over 100 chapters/branches, to alleviate the suffering caused by schizophrenia and related mental disorders. To this end, SSC and its provincial affiliates carry out public awareness & education, family support, advocacy and research funding initiatives and programs."
Schizophrenia Society of Canada
50 Acadia Avenue - Suite 205 Markham, ON L3R 0B3
Tel: (905) 415 - 2007 Fax: (905) 415-2337
Call Toll Free in Canada: 1-888-SSC-HOPE [1-888-772-4673] e-mail: info@schizophrenia.ca
http://www.schizophrenia.ca/******************************************************
Schizophrenics Anonymous (SA):"Schizophrenics Anonymous (SA) is a self-help group for persons who have schizophrenia or a schizophrenia-related illness. .A was founded in the Detroit area in July of 1985 and since that time, thousands of people have participated in meetings. There are currently more than 150 groups meeting throughout 31 states, as well as Australia, Brazil, Canada, Mexico, France, India and Venezuela. Statement of Purpose: Schizophrenics Anonymous is organized and managed by persons experiencing schizophrenia or a related disorder. It is administered in partnership with the National Schizophrenia Foundation. 403 Seymour Avenue
Suite 202 Lansing, Michigan 48933
Phone: (517) 485-7168 (800) 482-9534 (Consumer Line) Fax: (517) 485-7180
General Questions: inquiries@nsfoundation.org
http://www.sanonymous.org/******************************************************
WFSAD: World Fellowship for Schizophrenia & Allied Disorders:"The World Fellowship for Schizophrenia and Allied Disorders (WFSAD) is the only global organization dedicated to lightening the burden of schizophrenia and allied disorders for sufferers and their families. WFSAD strives to increase knowledge, understanding and compassion and reduce the fear, stigma, discrimination and abuse that accompany these difficult conditions. WFSAD and its member organizations focus on the humane treatment of people with mental illnesses and on their primary care, which falls frequently upon the family, most often the parents, and can last a lifetime. There is need for housing, rehabilitation, recreation and a decent life for those battling these difficult conditions. It is estimated that some 40% of sufferers have no contact with formal mental health systems. Support, training and education is necessary for families and their sick loved-ones, who have an enormous and continuing burden to shoulder."
124 Merton Street, Suite 507, Toronto, Ontario, M4S 2Z2, Canada
Tel: +1.416.961.2855 Fax: +1.416.961.1948 E-mail: info@world-schizophrenia.org
http://www.world-schizophrenia.org/See also: Addictions, Substance Abuse, Mental Health Abuse
Clinical Nursing Case Studies, Malpractice Cases: http://www.nursingcasestudy.com
October 15, 2000: Physician Restraint Orders Unclear On Transfer, Do You Apply In The Interim?
Summary: The use of Mechanical or Physical Restraints on confused patients is highly controversial. Due to substantial Death & Injury attributed to their use they are considered a last resort measure in providing for the safety of a patient. In this case, orders specifying what restraints and when they were to be used were unclear. In a patient that was clearly at high risk for injury, should they have been applied till the physician could have been contacted?
Tousignant v. St. Louis County, 602 N.W.2d 882 - MN (1999)
http://www.nursefriendly.com/nursing/clinical.cases/2000/101500.htm******************************************************
September 19, 1999: Abusive Psychiatric Patient Restrained, Placed In Seclusion For Angering Nursing & Medical Staff?
Summary: In dealing with violent, abusive or angry psychiatric patients, the safety of the patient and staff are the priority concerns. When restraints or seclusion are deemed necessary, justification for the measures must be documented concisely. In this case, an unruly patient angered the nurse caring for him. When leather restraints were applied and maintained for a prolonged period of time, the patient would object and later sue for damages.
Alt v. John Umstead hospital 479 S.E. 2d 800
http://www.nursefriendly.com/nursing/clinical.cases/091999.htm******************************************************
August 15, 1999: Violent Psychiatric Patient Attacks Nurse,
No Legal Recourse Against Facility or Psychiatrist?
Charleston v. Larson, 696 N.E. 2d 793 – IL 1998
Summary: It would seem absurd, that if a physician admits and facility assigns a nurse to care for a known violent patient, that it has no legal obligation to protect that nurse against violence. In this case, a psychiatric patient sought admission to facility. On admission, he threatened to attack a nurse. When the patient would follow through on his threat, the nurse was denied legal recourse against the psychiatrist who could have taken precautions against the attack.
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Direct Patient Care Resources:
Violence & Violent Patients, Direct (Bedside Nursing) Patient Care
http://www.nursefriendly.com/violent/******************************************************
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Drugs, Prescription Medications:
Abilify, Aripiprazole, Antpsychotic, Prescriptions Drugs, Medications, Medicines
http://www.prescriptionforviagra.com/abilify******************************************************
Ativan (Lorazepam), Anti Anxiety, Antianxiolytic, Sedative, Hypnotic
http://www.prescriptionforviagra.com/lorazepam/******************************************************
clonezapam (Klonopin), Benzodiazepines, Anticonvulsants, Antiseizure
http://www.prescriptionforviagra.com/clonezapam******************************************************
Ropinirole Hydrochloride, Requip, Parkinsons Disease, Dementia, Prescription Drugs, Medications
http://www.prescriptionforviagra.com/ropinirole/******************************************************
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Nursing Humor:
Psychiatric, Mental Health Humor
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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010
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