Mrs. Loughman works in a busy suburban emergency room (ER) as a geriatric clinical nurse specialist (GCNS). She has a master's degree in medical-surgical nursing. She has been in this position for three and a half years. Generally, forty thousand patients are seen in this ER with 30% composed of people 65 and older. As this ER is associated with a Health Maintenance Organization (HMO) all of the health care recipients are insured. Thus, the poor and very poor are not part of this nurse's population and less than 2% consist of any ethnic mix. The ER cares for medical and surgical emergencies and 20% non-emergent problems.
Education is a large of part of Mrs. Loughman' s role. She educates client and family, nursing personnel and ER staff and teaches in the community as well. Her practice is limited to those home-going elders, 65 and older. A good part of her care stems from her assessment of the cl
I find nursing to offer so many rewards such as knowing that you have made a difference in someone's life and nurses can expect to find employment readily available nationwide.
Often many of the patients in the ER are all referrals to the GCNS. She moves quickly through charts to decide what patients can wait until later or have a follow-up telephone assessment the next day. Patients with complex problems get her immediate attention and she collaborates with the nurses and the ED physicians. Usually, she assesses 6 patients per day plus tries to follow-up with patients that were referred while she was not working. Patients can call her anytime and she does short-term case management referring the client on to other health care providers. It can be a very hectic day with lots of patients. Even if the ER is slow, she alway
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