Fundamentals

The Health Care Delivery System

1. You are a home health care nurse scheduled for a home visit to your patient, a retired account payable clerk who is 7 days postsurgical with a new colostomy. Your patient lives with her husband who is involved in her care; they compile a list of questions between visits to ask upon your arrival at their home. During this visit, the patient has questions regarding her colostomy equipment and stoma care; her husband has questions regarding his current medication regimen. Both of them express concerns over recent changes in their health care coverage. 

a. What data in the scenario are pertinent?

b. Outline your nursing care responsibilities, as the home health care nurse, in this scenario. Compare and contrast these responsibilities with those found in the acute care setting.

c. What would be your recommendation for the husband’s medication questions?

d. What is the home health care nurse’s role and responsibilities related to the challenges of health care reform?

2. You are a nursing student attending clinical at a large, urban university hospital where you engage in direct patient care with clinical instructor supervision. At the nurses’ station, you overhear various nurses addressing patient care needs, including an RN requesting consults with a physical therapist, a respiratory therapist, a dietitian, and a social worker. Another nurse discusses the potential

need for palliative or hospice care consults for a patient. You observe a physician assistant approach the nurse with a list of written orders. 

a. Outline the roles of the various licensed health care workers mentioned in this scenario.

b. Compare and contrast palliative and hospice care. What is the major difference between the two?

c. As a nurse, what is your responsibility regarding physician assistant (PA) orders?