blondeez

I can appreciate your opinion. The I.O. stands for injured worker. Unfortunately, I was not provided with any templates or resources. I do not go in the exam room during the IME, which was authorized due to an exhaustion of all alternatives. I have done all sorts of nrsg, and definately had hesitations going into work comp. I can pleasantly say, it has been rewarding, and I can definately see the need for nurses in such. I have assisted my clients in receiving quality care, decreased pain, and of course, not only a RTW, but a return to life. I feel the system would be much more tolerable for everybody if nurses were hired more often! Hope you get feeling better!

I am a brand new case manager who is attending an IME with an I.O. in the am. I was just told I need to present a letter to the physician. What are the vital components. I have no resources on this, and nobody I can call. Any advise on the letter or anything else is greatly appreciated! Please help!

Maybe this well help. There is minimal to nil info RE functional position (if you see the word functional used, rehabilitation books often help), but through experience I will share what I know. Joints, should have slight flex, avoid hyperextension of knees, wrists, neck, etc. Hips should have a pillow between to avoid crossing, no abduction, adduction, Neck and spine should be in as straigt of line as possible. And, as previously mentioned, use hand rolls. This posistion helps to prevent complictions, joint stiffness, circulatory probs, contractures, and skin breakdown, and offers the pt. comfort. When positioning, remember to individualize, such as, is the pt. having SOB? Any skin breakdown? What is the affected side? There are many more factors your instructor can assist you with . After posistioning a pt, take a look, does anything look unatural or uncomfortable. If so, it probably is. This is a drill I recommend to my students, lay in a side lying position, what feels comfortable, then practice on each other, with attention to each joint. Hope this helps.

A complex case. I am assuming you are a senior. Do not get overwhelmed. With ABC's in mind, Step out of the room, take a breath, and think, what is the actual problem we are addressing, dealing with, intervening? Are you intervening in a way primarily to keep the person safe? How is the UO? No matter how complex the case, take your data, identify the prob, make a plan, and go from there. Alot of time the rest well fall into place. I would review your head to toe assessment and assess as much as possible. Gather data, highlight abnormals who cares what texts say at this time, this is your assessment. This makes it easy to identify actual problems requiring intervention. . Once you have a grasp of the individual case, then dive into the textbooks. Constantly referring to the textbooks and trying to understand the enormous amounts of text causes brain overload, and sometimes causes us to miss what is right before our eyes. Good luck.

I hope this helps. Usually, Risk for does not require a manifested by, otherwise, it would be a Actual dx. (Some instructors may require M/b, I never did.) Also, when prioritizing, remember you ABC's (airway, breathing, circulation). Safety/Falls is also high on the priority list, especially for a head injuries, seizures, etc. It sounds like the profile supports a perfusion issue (remember ABC). I would develop this , if the profile gives actual data to support it. Pain is also an actual issue, and these are actually easy, basic plans to develop. Your train of thought is going the right way. Try not to make this first care plan to complex, these take practice, but it will click.