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Outpatient, Term Paper Example

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Introduction

The outpatient setting for Multiple Sclerosis at Holy Name Hospital provides much-needed care and treatment for patients with this debilitating condition. It is important to address the challenges associated with providing successful care, therapy, and treatment for this patient population. In particular, staff nurses who work directly with patients must demonstrate adequate knowledge regarding the disease and a high degree of compassion for their patients. This information will be useful in demonstrating that the outpatient setting for MS patients at Holy Name Hospital is of the highest possible quality. For the following discussion, I interviewed a nurse manager with five years experience in the outpatient clinic working with MS patients at different stages of the disease. She is a certified nurse practitioner and earned her MS in 2000. Prior to her current work experience, she was employed as a staff nurse on an internal medicine unit at the same organization.

In this outpatient setting, it is evident that budget constraints have not limited the services that are provided to patients because the demand for services is very high in this community. However, at the present time, one support staff position remains unfilled due to these budgetary concerns and has placed a greater burden on the nurse manager and other support staff so that the level of service is not minimized. The nurse manager appears to have a clear understanding of the concerns that are evident in the clinic, but she does her best to overcome these problems through commitment, focus, concentration, and a high level quality of work at all times. With the shortage of one full time support staff member, the outpatient clinic faces a continuous burden with massive amounts of paperwork that have not yet been completed. The lack of completion of all paperwork indicates that financial forms are not complete and other filing must be accomplished. Furthermore, the trend throughout the healthcare industry to provide fewer and lower reimbursements continues to choke an already strapped healthcare system. Holy Name Hospital is not exempt from these regulations and cutbacks in payments. Therefore, the hospital must identify new sources of revenue to continue to accomplish its desired objectives for its patients, including those with MS.

From a patient care perspective, it is evident that the MS patients who visit the clinic continue to face different types of challenges which create a strain on their overall health and wellbeing. The nurse manager is responsible for ensuring that patient care is not compromised and that by visiting the clinic, their needs will be met, both physically and emotionally. The nurse manager notes that the quality of care and attention that is paid to these patients is unsurpassed in any other unit at the hospital. The care that is provided in this clinic is exceptional because each and every staff member takes the time and makes the effort that is necessary to support this patient population at the level that they require to achieve improved health and wellbeing. This is a continuous challenge for these patients but their needs are met in the clinic setting as best as possible. For this patient population, rehabilitation is critical to their ongoing development and quality of life and requires significant attention to education regarding self-care activities and emotional support for possible anxiety and depression. These events are common for MS patients and should be evaluated on a regular basis in order to achieve the desired patient outcomes and to improve overall health and wellbeing.

In response to the challenges of care and treatment for MS patients, it is important to address some of the most relevant challenges that Holy Name Hospital faces with respect to its current structure. This information plays a significant role in how the organization cares for its MS population and the resources that are available to accomplish the desired objectives. This promotes greater support and wellbeing for patient care and treatment for this unique population group. The following table will summarize some of the most important issues that Holy Name Hospital faces with respect to its MS population and how the information provided in the interview with the nurse manager plays a role in these processes:

Prior Research	Interview Method
Treatment adherence for many MS patients is difficult to sustain, particularly when there are frequent physical challenges and parenteral administration of fluids and/or medications are required (Patti, 2010); Adherence rates for medication are historically low, around 50 percent (Patti, 2010)	The nurse manager stated that one of the most significant problems with the MS patient population is treatment adherence, specifically with medications due to the challenging nature of administering medications through parenteral means
Many patients with MS suffer from persistent fatigue and find it difficult to perform any activity for a lengthy period of time (Braley and Chervin, 2010); furthermore, “fatigue in MS patients may be multifactorial. In addition to immunologic abnormalities, multiple sclerosis is associated with an increased prevalence of other conditions that contribute to fatigue, including depression and several sleep disorders” (Braley and Chervin, 2010)	Many MS patients who visit the outpatient unit suffer from fatigue of varying severities and require routine monitoring in order to determine how to manage fatigue as best as possible. Besides the traditional symptoms of MS, fatigue is very challenging to this patient population and requires considerable time and patience to overcome severe bouts of this condition.
Patient rehabilitation techniques for MS address such measures as coping with the condition, the quality of life that is achieved, the development of smaller and achievable goals (Sorensen et.al, 2012). Options for MS patients include rehabilitation that is individualized for each person based upon the stage of their condition and their overall health (Sorensen et.al, 2012)	MS patients at the clinic face considerable challenges in their efforts to achieve an acceptable quality of life. Therefore, the rehabilitation services that they receive are specific and customized to meet their needs. This improves the possibility that these services will be effective in treating patients and their conditions in a comprehensive manner.
Relapsing-remitting MS is very common and requires significant attention to ensure that periods of decline are properly evaluated and patients are treated to meet their needs accordingly (Motl et.al, 2011)	Patients who face a cycle of relapse and remittance on a regular basis are common visitors to the outpatient clinic and require treatment to minimize their symptom flare-ups to improve their health.
Patients with MS often experience depression due to their diagnosis and find it very difficult to overcome these circumstances without significant support and guidance from clinical caregivers (Motl et.al, 2011); this condition often worsens depression because of the inability of patients to perform even basic physical functions when the disease has progressed to a more advanced level (Motl et.al, 2011)	Patients who visit the clinic often appear depressed as a result of their conditions. This is a common phenomenon and reflects the challenges of patient care within this population group that will effectively balance their physical limitations and other symptoms with an improved mental state and outlook on life.

References

Braley, T.J., and Chervin, R.D. (2010). Fatigue in Multiple Sclerosis: mechanisms, evaluation, and treatment. Sleep, 33(8), 1061-1067.

Motl, R.W., McAuley, E., Wynn, D., Suh, Y., and Weikert, M. (2011). Effects of change in fatigue and depression on physical activity over time in relapsing-remitting multiple sclerosis. Psychology, Health & Medicine, 16(1), 1-11.

Patti, F. (2010). Optimizing the benefit of multiple sclerosis therapy: the importance of treatment adherence. Patient Prefer Adherence, 4, 1-9.

Sorensen, J., Lee, A., Lovendahl, B., Norgaard, M., Bay, J., Vestergaard Rasumussen, P., and Boesen, F. (2012). Study protocol: to investigate effects of highly specialized rehabilitation for patients with multiple sclerosis. A randomized controlled trial of a personalized, multidisciplinary intervention. BMC Health Services Research, 12, 306-315.