Tiffany Moore

As a home health nurse, I provide total care to a 55 year old female with developmental disabilities. My patient, who is 24 hour care, is affected by cerebral palsy, epilepsy, and has a gastronomy tube. She's also quadriplegic; therefore it is my responsibility to do daily skin assessments and be consistent with repositioning. She has a history of decubitus ulcers so it is important in preventing reoccurrences. In the event that precautionary measures are unsuccessful, wound care is administered per orders. She also has contractures which makes ADL care challenging due to osteoporosis. Every movement must be preplanned to prevent spontaneous fractures. Vitamin D is among the medications administered to assist with deficiency, yet one of the side effects to her seizure meds is decreased bone density. Since she is on aspiration precautions, the head of her bed must remain elevated when receiving her enteral nutrition. All medication and fluid intake is given via g-tube. Education, monitoring, and documentation are essential tools required to perform my duties as her nurse. Occasionally, there will be a break-through seizure in spite of medication levels. As a nurse, using critical thinking and evidence based practice alerts me to assess for constipation. After identifying that she is impacted, a digital rectal enema, DRE, is performed to alleviate the potential for further complications. It is also my responsibility to communicate any changes in the status of her health to the healthcare team and other legal parties involved in her well-being. Semi- annual well checks and follow-up appointments are included in the plan of care for my patient. She is nonverbal so an established rapport is required to provide proper care for this individual. The Wong-Baker Faces Pain Rating scale is effective in assessing her pain, as well as limited verbal prompts, i.e. eye blinking, groans, or turning her head to the left or right. Providing care with a personal touch has increased life expectancy for my patient by 34 years. I've had the pleasure to serve her for 29 of those years.