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TEAM P
RESENTATI
ON
MR
. BO
B S
MI T
H
Jessica CarpenterDream ClarkCharlotte LachapelleAshley MeadowsRachit PatelAmy PenhallMegan PodwinskiHirenkumar ShimpiKatelyn Tardif
SCENARIO
Mr. Bob Smith is a 55 year old single male. He has a great paying job in a factory that allows him a very carefree life style. Besides being a smoker for 25 years, Mr. Bob is a healthy man. Mr. Bob was involved in a very serious car accident while driving home from work late one evening, sending him to the hospital. Mr. Bob was taken to The Greater Toronto General by ambulance with life threatening injuries.
Mr. Bob spent more than six months in hospital, three months of that time was spent in a rehabilitation center to prepare for his life as a paraplegic. Mr. Bob has endured many hours of therapy trying to regain his upper body muscle strength to compensate for his lower loss. Mr. Bob now also has a colostomy bag and will soon be fitted for dentures as he lost or damaged most of his teeth in the accident. Mr. Bob who was once very independent is having trouble adjusting to all the assistance he will need when returning home, as well as his new financial restrictions. Mr. Bob will continue to receive care from PSW's in a homecare setting every other day for 2 hours to assist with bathing, meal preparation and light housekeeping. Mr. Bob is now able to toilet himself, however now requires assistive devices in the bathroom to ensure his safety.
Mr. Bob is on several different medications for pain management but feels he knows nothing about his medications and fears when he is home he will mix them up or take them at the wrong times.Becoming completely overwhelmed by all the new information as well as fear of not being accepted Mr. Bob has begun to isolate himself, staying in his room most of the time. He states that it’s just easier due to the fact that he has a 3 story house and his room is on the top floor. Family and friends fear for him if this behaviour continues.
RECREATIONAL THERAPISTS ROLE
Recreation Therapy for Mr. Bob Smith
As Mr. Bob Smith’s Recreationist I plan on asking him about his past and current leisure status this will help me see his hobbies that he used to enjoy and may be able to enjoy once again and it also allows me to brainstorm new leisure and recreation opportunities that he may come to like. Mr. Bob Smith has been isolating himself from family and friends so another goal as his Recreationist would be to encourage his family to visit more often and attempt to play a game that may stimulate his mind or body. I would also encourage Mr. Bob Smith to join local clubs or sports teams to become more socialized. Mr. Bob Smith is facing some financial restrictions due to the time off of work so I would like to suggest some community resources for him that can assist him in meeting his leisure needs. To keep up with Mr. Bob Smith’s therapy to assist in bring back muscle strength in his upper body I would encourage him to play games such as ping pong in his leisure time.
DENTAL ASSISTANTS ROLEDental Assistance for Mr. Bob Smith
As Mr. Bob Smith’s Dental Assistant I will assist him and the Dentist in the procedure of fixing his damaged teeth as well as providing advice on oral care for his dentures. I will also advise Mr. Bob Smith to attempt to quit smoking or to at least cut down the amount of cigarettes he smokes. This puts Mr. Bob Smith at higher risk for attracting gum disease, Cancer of the mouth as well as many other infections.
PHARMACY TECHNICIANS ROLEAs Pharmacy Technician I will compound the medicines for pain
in appropriate dosage form which are compatible to take for Mr. Smith. If he is good with oral liquids, I will compound pain killer suspensions for him otherwise he can take tablets or capsules if he wants. I will compound the medicines according to his taste or flavour he likes and also give it in different colours so that it will be easy for him or to his PSW to identify them. I will give him pain killer according to his need and fix the schedule of medication very convenient. I will also help Mr. Bob by giving him home delivery. If Mr. Bob have a health plan I will help him by processing his claims and other reimbursement services. Along with Pharmacy Assistant we give our best to serve health care from our side and help Mr. Bob to get well soon.
RETAIL PHARMACY ASSISTANTS ROLE
As the pharmacy assistant I will first gathered all details from the pharmacy technician in regards to other medicines Mr. Smith may be taking to insure all medications are safe to be taken together, and I will prepare easy to remember schedules for taking these medications. One example would be blister packs which will show times, days and quantity of medications which he should find very beneficial . I will also give a copy of this schedule to his health care team. I can also show family/friends or even his personal support worker how and when to call in his prescription refills. I can also arrange medication delivery to assist him in receiving his medications if that becomes a concern for Mr. Smith. I would also have all medication information regarding his medical history which can be useful to him for future references.
REGISTERED PRACTICAL NURSES ROLE
Nursing Assistance For Mr. Bob Smith
As Mr. Bob nurse I would be responsible for Mr. Bobs daily assessments, creating and implementing a care plan, health teaching for him and his family members to prepare him for discharge, medication administration and following and implementing all doctors orders, documenting any improvements or issues to be shared with Mr. Bobs health care team insure Mr. Bob is receiving the best patient care.
PERSONAL SUPPORT WORKERS ROLE
Personal Support Assistance For Mr. Bob Smith
The personal support worker assisted Mr. Bob while in hospital with all activities of daily living (ex., bathing, perineal care, personal hygiene, toileting, feeding, oral hygiene, emptying his colostomy bag and changing it.
Once Mr. Bob comes home, he will still be receiving care every other day for 2 hours for bathing, meal preparation, and light housekeeping.
OCCUPATIONAL THERAPISTS ROLE As Mr. Bob Smiths Occupational Therapist I plan to first ask him questions
about his daily routine and how he manages with his self-care and other activities of daily living. With this information, I may look into what difficulties Mr. Bob Smith is having with his routines and what possible assistive devices I could look into that will be beneficial to him. For example, a reacher to help him get certain objects that he needs to help to get. I could also complete a home safety assessment and then help him with making his home safer and easier to live in. An example would be to add bars in his bathroom so that it would be easier for him to get in and out of the bathtub, and to take things down from higher shelves to make things more accessible to him. Something else I could do is to fit Mr. Bob Smith for a wheelchair so he will be able to move around, and to teach him and his family how to properly transfer him from out of his wheelchair and onto other surfaces. Lastly, I can also teach Mr. Bob Smith about further injury prevention, and help to teach him ways that he can conserve energy.
PHYSIOTHERAPIST ROLE
As the PT in this case, I am looking at Mr. Smith’s functional ability. With having this accident he is now a paraplegic and will be relying greatly on his upper body to help complete daily tasks, moving around. To begin I completing several assessments with Mr. Smith including goniometric measurement, and MMT to determine the mobility and strength he has with his upper body. As for the treatment plan I will be incorporating strength training to help build the muscle in his arms with manual resistance and eventually weights and Theraband as the resistance with progression, as well as ROM in the lower body to prevent contractures.
I do work closely with the OT in the interprofessional team and as she already mentioned safe transfers is very important for Mr. Smith. The OT will be working with Mr. Smith’s family to help him with transfers and as an expected outcome we hope to help increase his independence in completely transfers with a transfer board; which again will come in time because one needs strength in their upper body to complete this task.
Finally, we will be working with the rest of the interprofessional team to ensure that Mr. Smith is experiencing minimal pain – from medications to therapeutic modalities such as crynotherapy, heat packs, or even TENS. By reducing the amount of pain this will help encourage Mr. Smith to be co-operative in his treatment plan.
OCCUPATIONAL THERAPIST ASSISTANT AND PHYSIOTHERAPIST ASSISTANTS ROLE
As the OTA and PTA I will be carrying out the treatment plans prescribed by the OT and the PT. Mr. Smith is in a wheelchair prescribed by the OT and as the OTA & PTA I am able to educate Mr. Smith on proper use of the wheelchair such as safety factors. Especially when I am working with Bob to do transfers I will be making sure that he always turns the brakes on before trying to move out of his chair. While Mr. Smith is in the hospital I will be assisting with ambulation whether it be walking or transferring to and from his wheelchair.
I will also carry out the treatments established by the PT such as ROM (helping with circulation and movement with the lower body), as well as strength training; which entails me to ensure Mr. Smith is doing his exercises properly getting the full benefit.
Also a very important role for me as the OTA and PTA is documenting and communicating with the OT and PT of how Mr. Smith is responding to treatment and any concerns or restrictions that I feel are necessary for the OT and PT to be aware as this could indicate a problem with the treatment plan.
PARAMEDICS ROLEAs the Paramedic on call during this car accident, my duties
were to keep Mr. Smith alive during transportation to the hospital where he would receive more intense health care. During the car accident Mr. Smith sustained serious life threatening injuries. Being the paramedic I needed to stop all bleeding, manage pain via medication, and maintain breathing and heart rate. As a paramedic my mind set is based on ultimately reaching my goal of performing priority assessments and interventions. The assessments would aid in helping the staff at the hospital to have a background on the client prior to or during admission of the ER. The interventions that would be performed would only be short term and would need to be addressed upon arrival at the hospital.
