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Mrs. Rojas, a 56-year-old Mexican American with heart failure requiring home infusions of Dopamine, has been...

Mrs. Rojas, a 56-year-old Mexican American with heart failure requiring home infusions of Dopamine, has been referred to a local home health infusion company following discharge. An appointment with the pharmacist and IV infusion nurse has been made with Mrs. Rojas and her family in her hospital room prior to discharge so the family can receive the appropriate education. The appointment time was arranged for “lunchtime.” When the pharmacist and the nurse arrived, they had to wait for over an hour before meeting with the client and her family and the family did not apologize for the delay. Since the pharmacist and nurse were rushed for time due to many appointments that day, they became impatient and irritable with the family. The Rojas family, sensing their apparent irritation, became withdrawn, not participating in the client’s care. The session became a waste of time since home care instruction is impossible without the cooperation of both the family and the client. The pharmacist and the nurse told the discharge planner the family was not able to be educated on the appropriate techniques for the client’s care and home IV therapy was inappropriate. Case studies adapted from Galanti, G. (1997). Caring for patients from different cultures: case studies from american hospitals (2nd ed.). University of Pennsylvania Press: Philadelphia, PA. Discussion Questions: Think about the roles of the different players in this situation and how they interact. If you were the bedside nurse caring for this client, how would you respond to the different players? What were the barriers you identified in the case study? What nursing interventions could you have done to prevent the situation that developed? Based on those interventions, identify how the barriers would have been eliminated. Read your fellow classmates' discussions. Respond to at least one other classmate's discussion. Search entries or author

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The role of pharmacist and nurse was to give home infusion of Dopamine to Mrs.Rojas who was suffering from heart failure.Mrs.Rojas and her family members must co-operate the pharmacist and nurse and take their service on scheduled time and they apologize for the delay so that a healthy relationship should be established between the patient care provider and patient.

If I were bedside nurse caring for this client ,I politely requested to Mrs.Rojas and his family to co-operate with her and take your service on time from next visit as time is very time in health care so that she can provide her service to other clients also .

Berrier identified in the case study are:-

- Communication gap between the family member of Mrs.Rojas and pharmacist and nurse.

- Caring of patients from different cultures is difficult .

- Inappropriate education technique for client care may be one of the barrier.

-Medication management at home care is difficult.

Nursing intervention to prevent the situation or barriers that developed are:-

--Proper communication between the patients and her family members ,phramasist may solve the situation .

- Importance of medication management at home care should be clearly explained to the patient and her family members.

-Appropriate educational technique for client care should be dealt properly

Classmate discussion about his client:-

In a hospital,nurse ,physician and pharmacist may all play a role in ensuring that patient received antibiotics at therapeutically appropriate intervals .At home however the patient may choose to take medication at irregular times,despite advise about important of a regular medication schedule.

In short we can say that management of patient at hospital and home care facility with nurse or other health care professional may differe.

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