Exciting Updates from the Worker Bee!

It's been an exhausting week and it's only Wednesday. The project that I was hired for is up and running. We officially have two - count them - two patients! We had our first clinical meeting today with our funders (they're the ones giving us the patients) and they were very pleased with our progress. They plan to give us a ton of new referrals, to the point that we will have all of the patients needed to complete our research project. This is terribly exciting and completely stressful at the same time. I was asked today by the VP of Research to write up a "vignette" or "case study" to be included in the quarterly report to the major funders. I was told this afternoon to create this by tomorrow afternoon. For some reason, I got a wild hair up my ass and worked on it at home (I never work at home!) I'm including it in this post in the hopes of some feedback! This will also give you guys an idea of what I actually do.

Here it is, my first foray into publishing:

"Julio" is a 58-year-old male, a native of Puerto Rico, who has been living in Brooklyn since he was eighteen years old. Several years ago he was diagnosed with high cholesterol, hypertension and diabetes. He has Health Plus managed Medicaid and has been receiving disability benefits, as well as welfare assistance in the form of food stamps. He has lived in the same one-room cluttered apartment for seventeen years, sharing a bathroom and kitchen with the other six residents on his floor. He was referred to the Health Plus at Home program for management of his chronic illness, psychosocial support, referral services and assistance in maintaining his Medicaid.

Attempts to contact "Julio" by phone were unsuccessful due to the lack of a working telephone number. The Health Plus at Home team consisting of a Nurse and Social Worker contacted him by arriving at his apartment unannounced in the hope of enrolling him in the program. He was appreciative of the home visit and pleased with the offer of in-home case management. During the initial contact it was revealed that he also had coronary artery disease, damage to his liver, glaucoma, and cataracts. He revealed that he was an alcoholic and requested assistance with making medical appointments.

During the initial psychosocial assessment, he admitted to consuming 12-18 beers per day in order to "forget". He suffered depression resulting from the loss of a young son, a bitter separation from his first wife as well as the death of his long-term girlfriend and most recently, the death of his cat. He exhibited symptoms of anxiety stemming from a crippling fear of the possibility of injury while venturing outdoors. He would like to overcome his anxiety and reduce his depression as well as his alcohol intake. Supportive short-term counseling will be provided by the Health Plus at Home Social Worker prior to making an outside referral for continued psychotherapy in the community.

During the initial nursing assessment, he expressed his concerns about foot pain as well as an inability to read his medications or his insulin due to his poor eyesight. He noted that he misses most medical appointments as a result of depression and not wanting to leave his home. He has difficulty re-scheduling missed appointments and scheduling new appointments because of being put on hold and not having enough minutes on his cell phone to wait. His first request was for assistance in making a podiatry appointment. The Health Plus at Home team contacted his podiatrist and made a last-minute appointment for him to attend. Even though he expressed concern about leaving his home, he attended the appointment and received a much-needed prescription for orthopedic shoes.

The Health Plus at Home team initiated dialogue with his primary care physician and made plans to further assist him in making and keeping medical appointments. The Nurse created a large-print medication list and schedule to promote continued medication follow-through. The team will continue to educate "Julio" about his illnesses and to act as a bridge, fostering better communication between he and his healthcare providers.