Chapter 2

My Professional Opinion

Each member of the interprofessional healthcare team has different information about the patient. They also have different professional lenses, which influence their opinion. Because I spent a lot of time with the patient, I had both medical and personal information about him, his family and his life.

What I knew about the patient...

What I knew about the patient...

Reason for Hospitalization

The patient was hospitalized for a fractured hip and he’d spent 6 weeks in rehabilitation.

History of Injury

Prior to hospitalization, the patient had fallen many times within his home.

Life at Home

The patient was the primary caregiver for his wife, who had dementia. His wife was not able to assist him in preparing meals, drive to get his medication or assist in his care. She required care herself.

Social Support

The patient and his wife immigrated to Canada when they were in their twenties. They didn’t have any children and most of their family lived back in their home country. This meant they didn’t have many people that they could turn to for help or support.

Financial Issues

Because the patient and his wife owned a small business, they had limited retirement income. The patient’s care needs would likely place a great financial burden on the couple.

Discharge Plan

According to the discharge plan, it was time for the patient to be sent home. But an important part of the discharge process hadn’t been completed. There hadn’t been a home care assessment to determine what support the patient would need to make a full recovery at home.

My Professional Opinion

In my professional opinion, it was too early for the patient to be discharged. Because the homecare assessment hadn’t been completed, I didn’t feel that the patient and his wife had enough support to transition safely back home.

Questions for Herminia

The role of the nurse includes competency to conduct multiple assessments not just physical assessments but also environmental, psychological, social, behavioral and risk assessments such as risks for potential falls. Home care assessments include equipment and safety assessments for transition of care from hospital to home. It is conducted by the Home care office Care Coordinators, but as the nurse caring for the patient, the nurse needs to conduct, document and share these assessments with the team. Check out the Registered Nurses Association of Ontario website for many best practice guidelines that will be a great resource to help you learn evidence informed care.

Well done. You've completed module two!