Test 2 of 33

OET writing sample test 2 for nurses

OET Writing sample test 2 for nurses
OET Writing sample test 2 for nurses

OET Writing sample test 2 for Nursing

Welcome to a new OET writing sample test 2 for nurses from OET2.com.

You will have 5 minutes to read the letter and 40 minutes to write your answer.

We do not guarantee a free correction of letter, but we will do our best to evaluate it.

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Responses

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  1. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    3rd January 2018

    Re: Ms. Caderina Piper, aged 90

    Dear Ms. Sandrine,

    Ms. Piper, who was admitted at Beacham Ambulatory Care Center due to a relapse of her psychotic symptoms, is being discharged today. Your ongoing support is requested.

    Ms. Piper was diagnosed with post traumatic stress disorder following a robbing incident at her home in October, 2016. Her initial symptoms were delusion, confusion and emotional distress, which improved gradually after 2 months. On March, 2017, her emotional distress reoccured accompanied by depression.On November, 2017, she started to have psychotic symptoms and sever paranoia. In addition, she was also hallucinating that there are people in her bed. She was admitted in a psychiatric ward and her condition improved after 14 days without taking any antipsychotic drugs. However, her symptoms reoccured 2 weeks after she was discharged back to her senior apartment.

    During Ms. Pipers admission, she was commenced on Haloperidol 0.025-1.0mg/day and has been undergoing behavioral and exposure therapy. Additionally, she was referred to other therapist for further treatment.

    Currently Ms. Piper is emotionally stable but needs monitoring of her physical and psychological needs and condition.

    It would be appreciated if you could encourage Ms. Piper to share her feelings and concerns, accept her emotions and identify her ineffective coping mechanisms and their consequences. Also, please monitor her compliance to her medication and follow-up on her support system since she lives alone and her only next of kin talks to her once a month only.

    Please do not hesitate to call me for any queries.

    Yours sincerely,

    Nurse

  2. 3 January, 2018
    Ms Bhavana Sandrine
    Charge Nurse
    Palmer Home Care Facilitie
    Dear Sandrine,
    Re: Canderina Piper, Aged : 90-years

    Mrs piper is being discharge today, who has been diagnosed post traumatic stress disorder. She requires ongoing care and monitoring from your facility.

    Mrs piper was admitted on November, 2019 with persisting psychiatric symptome and she has made good prognosis after 14 days without medication.During hospitalization,she was gained appropriate support system and she was refered for another therapies. In addition, she was encouraged for identification of effective coping mechanism and consequence along with appropriate time given to listin her concers.Upon admission, she was on Haloperidol 0.025-1.0 mg/d, cognitive behavior and exposure therapy.

    Initially, Mrs piper was brought to our centre on October, 2016 because she was very distressed, delusional and confused due to robbery incident in her home. On subsequent days she recovered and back to Senior living building. However, On March 2017, her symptoms detoriated due to new environment. After nine months she moved to new facility ;eventhrough, her condition worsend she is hospitalized in psychiatric unit.

    In view of the above kindly assess her emotional support and monitor her medication compliance.
    In view of the above, if you require any futher information kindly contact me.
    Yours sincerely,
    Registered Nurse

  3. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    Dear Ms. Sandrine,

    Re: Mrs. Caderina Piper, 90 years old

    I am writing with regard to Mrs. Piper, a 90-year-old widow who was admitted to our facility due to post traumatic stress disorder as well as having anemia, osteoarthritis, and urinary incontinence. Although she is fully functional and independent, she requires your continued monitoring and management.

    Mrs. Piper started to manifest delusions after she was robbed at her home on October 2016. She had improved over 2 months and was discharged to a senior building community in eastern Baltimore County. However, her stay at senior building was cut short when she got depressed. Subsequently, she was moved to a new Senior Housing unit at her request.

    In November 2017, nine months after moving to a new facility, Mrs. Piper became acutely ill with severe paranoia and psychotic symptoms for which she got hospitalized and improved for 14 days on a psychiatric unit without medications. However, one week following her discharge from the hospital her symptoms rapidly recurred when she returned to the senior apartment.

    During her time in care, Mrs. Piper was encouraged to have proper coping mechanism, provided the time to explore her feelings and to acknowledge her emotions. Referrals for further cognitive behavioral and exposure therapies as well as support system was done. She was also prescribed with Haloperidol 0.025-1.0 mg daily.

    In view of the above, it would be greatly appreciated if you could continue the care of Mrs. Piper and to contact emergency number for suicidal attempt or any. Please also contact the doctor if she has sleeping difficulties or has been sleeping too much.

    Please contact me for any queries.

    Yours sincerely,

    A G
    Charge Nurse
    Beacham Ambulatory Care Center

  4. Ms Bhvba Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    26/9/2021

    Dear Ms Sandrine,

    Re; Caderina Piper (age;90)

    I am writing regarding Mrs Piper who was hospitalized to control her psychotic symptoms and severe paranoia related to post-traumatic stress disorder. Her condition was stabilised and she is ready to go back into your care.

    As regards medical management, Mrs Piper is on haloperidol 0,025-1,0 mg/day. In addition to that, cognitive behavioural therapy and exposure therapy were provided, in which she was encouraged to identify her neffective coping mechanisms and the consequences as well as to accept her emotions while adequate time for her to discuss and explore feelings was provided. At the same time, appropriate support systems and referrals for further therapies were developed.

    I appreciate your continuous care for Mrs piper and your careful observation as she rapidly aggravated her symptoms at the previous discharge. Please call the emergency number if she tries to hurt herself or others. Should she show any change in her sleeping habits, please seek a doctor’s advice.

    If you have any questions, please feel free to contact me.

    Sincerely yours,

    Nurse

  5. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03\01\2018

    Dear Ms. Sandrine,
    Re: Caderina Piper, aged 90

    I am writing this letter in regards with Ms. Caderina Piper. She was diagnosed with post traumatic stress disorder but is now fully functional and ready to be discharged back into your care.

    Ms. Pipers issues started when her home was robbed. She was distressed, delusional and confused. After 2 months her condition improved and was discharged to a senior living building in a community in eastern Baltimore County. 5

    1. Five months after the robbery, Ms. Piper is stressed about her new home and depressed with no signs of suicidal behavior. When she moved to a new facility, in November 2019, she presented whit psychotic symptoms, severe paranoia and hallucinations. Hospitalization on a psychiatric unit resulted in improvement with over 14 days without antipsychotic medication. Symptoms recurred after returning to the senior apartment.

      Ms. Piper was recommenced on Haloperidol 0,025-1.0 mg daily and cognitive behavioral and exposure therapy. She was encouraged to identify ineffective coping mechanisms and consequences and to accept her emotions. In addition, she was provided time to discuss and explore feelings and to develop appropriate support systems for ongoing therapies. Please note, administer medications as ordered.

      I would appreciate your continuous care and observations as her symptoms aggravated after previous discharge. Please call the emergency number if she tries to hurt herself or other. Call the doctor if she cannot sleep or is sleeping too much.

      If you have further quires, please do not hesitate to contact me.

      Yours sincerely,
      Charge Nurse

  6. Ms Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    RE: Caderina Piper, 90 years old

    Dear Ms. Sandrine,

    Ms Piper is due for discharge today from our hospital with a diagnosis of post traumatic stress disorder, pernicious anemia, osteoarthritis and urinary incontinence.

    On October 2016 her PTSD started when her home was being robbed and she was assaulted. She felt distressed, delusional and confused but was resolved in over 2 months time. Thus discharged to as senior living building in a community in eastern Baltimore County. In March 2017 she was seen again but with no improvement identified. She is still emotionally ill and requested to move to a new Senior Nursing unit which is near a bus route. But unfortunately, 9 months after her move, which is on November 2017, she started to experience psychotic symptoms and severe paranoia which prompted for another hospitalization in a psychiatric unit. Her symptoms was resolved after 14 days without giving anti-psychotic medications. When she returned home a week after, her symptoms rapidly came back thus admission in our hospital.

    During her hospital stay Haloperidol 0.025-1 mg/day was given. Therapies like cognitive behavioral and exposure was also facilitated by the doctor. We also encouraged her to identify which coping mechanism is effective and not. Assistance in her support system and therapies is also done. Since her symptoms are on and off kindly contact the emergency numbers if there is an event that she wants to hurt herself or other people. And please note of her sleeping patterns. If any abnormality is noted, contact the doctor about it.

    Please do not hesitate to contact me if you have any queries.

    Yours sincerely,
    Honeylore Pacio
    Charge Nurse
    Beacham Ambulatory Care Centre

  7. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    RE: Caderina Piper, 90 years old

    Dear Ms. Sandrine,

    Ms. Piper is due for discharge today from our facility with a diagnosis of post traumatic stress disorder, pernicious anemia, osteoarthritis and urinary incontinence.

    On October 2016, her PTSD started when she was assaulted and robbed at her home. She felt distressed, delusional and confused. She was then discharged to a senior living building in a community in eastern Baltimore after over 2 months of resolution of her symptoms. In March 2017, she was seen with no apparent improvement. She’s been down emotionally as evidenced by her depression, crying and being stressed at her home. She wanted to transfer to a new senior housing unit near a bus route. After 9 months of transfer which is in November 2017, she became very ill with psychotic symptoms(hallucinations) and severe paranoia. This prompted her admission in a psychiatric unit. It was then resolved after 14 days without administration of anti-psychotic drug. But unfortunately, a week after her return in the senior apartment , her symptoms came back, thus, admission in our care. Due to her unstable symptoms, kindly call the emergency numbers if she tries to hurt herself or other people. Please do monitor her sleeping patterns also and inform her doctor if you have noted any abnormality such as sleeping too much or not sleeping.

    Please do not hesitate to contact me for any query.

    Yours sincerely,

    Honeylore Pacio
    Charge Nurse
    Beacham Ambulatory Care Center

  8. 03 January 2018

    Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    Dear Ms Sandrine,

    Re: Ms. Caderina Piper, aged 90

    I am writing in regard to Ms. Piper who was admitted to our facility with the diagnosis of Post Traumatic Stress Disorder along with the chronic pernicious anemia, osteoarthritis and urinary incontinence. She is due to be discharged today with fully independent and functional, however, she still requires your ongoing health management and support.

    In terms of her medical history, Ms. Piper presented mental illness which includes distressed, delusional and confused due to the security issues at home on October 2016. It took her over 2 months or slowly improved. However, in 2017, her medical condition has been deteriorated with associated with emotionally and depressed, severe paranoia and hallucinates.

    During the time of care, she commenced on Haloperidol 0.025 to 1 mg per day along with the cognitive behaviours therapy and exposure therapy. As well as this, she has been encouraged to acceptance the emotion and to identification ineffective coping mechanisms and consequences. in addition, she has been receiving the adequate time to discuss and explore the feeling.

    It would be greatly appreciated if you could provide the ongoing management for Ms. Piper’s health condition. It is necessary to develop appropriate support system and to referrals for future therapies. Please call the emergency number if she has the signs of suicide or hurt others, and also please call the doctor if she has sleeping difficulty or sleeping too much.

    Please do not hesitate to contact me if you have any quires.

    Yours sincerely,

    Charge Nurse

  9. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    January 3, 2018

    RE: Caderina Piper, 90 years old; a widow

    Dear Ms. Sandrine,

    Thank you in advance for accepting my patient. This letter’s main intention is to endorse the above mentioned patient who has post-traumatic stress disorder; and also suffering from pernicious anemia, osteoarthritis and urinary incontinence. She would require your expertise and caring hand for further management of her condition.

    Ms. Piper is home alone and her nephew visiting her once a month. In October 2016 someone broke into her house and robbed her, this event made her distress, confused and delusional but she recovered slowly after 2 months at senior living building found in Easter Baltimore. Also, in March 2017 she suffered from depression and stress due to her new home so she moved in a place near the bus route where she can move around easily. 9 months after she moved to her new house she suffered from severe paranoia associated with psychotic symptoms and treated in a hospital without using antipsychotic drugs; the following week after discharged recurrence of symptoms rapidly noticed.

    She is currently Haloperidol 0.025-1.0mg daily and also participating in cognitive behavioral therapy and exposure therapy. Patient has been referred to other therapist for further assessment and management.

    It will be beneficial for her to explore and discuss her problems with you; and also identify any appropriate management to her condition. She needs to be reminded for her medication; call the emergency number if you notice any sign of self harm and call the doctor if the patient cannot sleep.

    Should you require any information, please do not hesitate to contact me.

    Yours sincerely,

    Redo Chioco
    Charge Nurse
    Beacham Ambulatory Care Center

  10. Ms Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    REF: CADERINA PIPER, 90YRS

    Dear colleague, please accept care of the above named patient who was admitted in our Facility with post traumatic stress disorder. She also has chronic pernicious anemia, osteoarthritis and urinary incontinence. She is able to do activities on her own.

    Mrs Caderina is widowed and has 1 nephew who communicates with her once a month.
    She suffered from distress and delusions in 2016 after an assault through a break in in her house. She how ever improved and was discharged to a senior living building.

    In March 2017 she was seen again in the Facility with depression with no signs of suicide, she was frantic about her new facility and wanted to be moved to a senior housing unit, she became very with signs of psychosis and paranoia which resulted in her being admitted in the psychatric unit. She is on haloperidal 0.025mg -1.0mg per day and on cognitive behavioral and exposure therapy.

    Patient has been encouraged to identify ineffective coping mechanism and their consequences, she has been allowed time to discuss and explore her feelings and also encouraged to accept her emotions.

    Please note that you need to call the emergency numbers if she becomes violent and to call the doctor when she shows signs of not sleeping or sleeping too much.

    Contact me if you need and clarify on her condition

    Yours faithfully
    In Charge Nurse

  11. Mr. Adrian Pacheco
    Charge Nurse
    Beacham Ambulatory Care Center

    Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home care Facility
    Baltimore

    3rd January 2018

    Dear Ms. Sandrine

    Re: Ms. Caderina Piper, 90-year-old female patient

    I am writing to you to discharge Ms Piper into your care. The patient has been diagnosed with Post traumatic Stress Disorder and recurrent development of psychotic symptoms after her home has been broken into and been robbed.

    Caderina has been suffering from depression and hallucinations treated with some cognitive behavioural and exposure therapy. Please take in consideration that is really important to encourage her to identify ineffective coping mechanisms and consequences as well as provide adequate time for the patient to discuss and explore feelings, accepting her own emotions. Please do not hesitate to contact the emergency number if Ms. Piper tries to harm herself and contact the General Practitioner if her sleep habit are disturbed in any way.

    Regarding her medication, Ms. Piper requires haloperidol 0.025 to 1mg a day. Also, the patient needs to be referred for further therapies as well as develop an appropriate support system.

    As regards her past medical history, the patient has been suffering from anemia pernicious, osteoarthritis and, despite her fully independence, urinary incontinence. There are not known allergies.

    Should you have any queries, please do contact me.

    Yours sincerely,

    Adrian Pacheco
    Charge Nurse

  12. Ms .Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore
    03/01/2018

    Re: Mrs Caderine Piper, aged 90

    I am writing to refer Mrs caderine Piper who has been diagnosed with PTS. She requires psycologial care and support from your facility.

    Mrs Piper experienced psycotic symptoms since 2016, october following a robbery incident at her home. Her symptoms included distress, delusion and confusion which was gradually improved over 2 months. On 2017, she suffered from depression accompanied by severe paranoia and hallucination consequently, she was admitted to the psychiatric unit and her condition was improved without antipsycotic medication.

    Subsequently following her discharge, her symptoms reoccoured rapidly for which she commenced on haloperidol along with cognitive behavioural therapy and other supportive therapy.

    Mrs Piper is emotionally stable ,however she requires monitoring for her psycological and physical
    needs.
    It would be grateful if u could monitor her compliance with her medications as well as psycological condition. Please encourage her to express her emotions and feelings and identify her coping mechanisms and consequences. Please contact immediately for any suicidal attempt or if she having issue with her sleeping pattern.

    Please do not hesitate to contact me if you require any further information

    yours sincerely
    Regd Nurse

  13. Ms. Bhavna Sandrine,
    Charge Nurse,
    Palmer Home Care Facility,
    Baltimore.

    03/01/2018

    Re: Ms Caderina Piper, Aged 90 years

    Dear Ms. Sandrine,
    I am writing to introduce Ms. Piper who has Post Traumatic Stress Disorder and needs your management and care.

    She is a widow with only one nephew with whom they communicate monthly. Besides Post Traumatic Stress Disorder, she has pernicous anemia, osteoarthritis and urinary incontinence although she is fully independent and functional.

    In October 2016, she was admitted following being distressed, delusional and confused after being robbed in her home. She improved after 2 months and discharged to a senior living building in Baltimore.

    In March 2017, she still had non suicidal depression, relating it to her new home and she requested to be moved to a new senior housing unit.

    Ms. Piper was admitted in a psychiatric unit in November 2017, following acute psychosis and severe paranoia associated with hallucinations. She improved after 14 days without any anti-psychotic medication. A week upon discharge, the symptoms recurred after her return to the senior apartment.

    Currently, she is on Haloperidol 0.025-1.0mg/day and undergoing cognitive behavioral therapy and exposure therapy. Please call the emergency number if she tries to hurt herself or others and call the doctor if she cannot sleep or sleeps too much.

    Please contact me in case of any concerns. Thank you.

    Yours sincerely,
    Daisy Wasilwa.
    Charge Nurse.

  14. Ms. Bhavna Sandrine

    Charge Nurse

    Palmer Home Care

    Baltimore

    03.01.2018

    Dear Nurse,

    Re: Caderina Piper, 90 years old

    I am writing to request your ongoing care for Ms Piper who was admitted to Beacham Ambulatory Care Center due to recurrance of her psychotic symptoms as a result of post traumatic stress disorder. She will be discharged today to your care.

    In terms of her medical history, she has chronic anemia, osteoarthritis and urinary incontinence. However, she is totally functional.

    Ms Piper was discharged from our facility to senior building community after hospitalized  for distressing and delusion of her home was robbed on october 2006. However, on March 2017, she was very stressed and depressed about her new place. After 9 months later, her conditions was deteriorated with severe paranoia and psychotic symptoms. Therefore, she was admitted in a psychiatric ward and her condition improved after 14 days without taking any medications.One week later after discharge from hospital, her symptoms was rapidly relapsed when she  was back to her apartment.

    During hospitalization, Ms piper was commenced Haloperidol 0.025-10 mg/day and has been undergone for behavioral and exposure therapy.

    It would be aprreciated if you could encourage to share her feeling and reassure her coping methods. It is worth to mention that Ms piper has  risks for self harm. Please observe her condition regularly and her mediacl adherence.

    If you have any questions, please do not hesitate to contact me.

    Yours Sincerely,

    Charge Nurse

     

     

  15. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    3rd January 2018
    Re : Canderina Piper(aged 90)

    Dear. Ms. Bhavena Sandrine

    I am writing letter for Ms Piper who was admitted due to post traumatic stress disorder. she is ready discharge to Palmer Home Care Facility today

    After Octorber 2016 to November 2017 she had shown psychotic symptoms and severe paranoia but during hospitalized She shown good recovery with symptoms for 1 week
    Now she is total independent for her self care and fuctional

    When on admission, she has taken haloperidol 0.025-1mg per day and congnitive behavioral therapy and exposure therapy
    she is really acceptable from this therapy
    she also trained to have any orientation of time, people and place and to expose her emotional situation to another
    she has taken all of medication as per perscribed

    It would be appreciated if you could keep monitoring for her mood and encourage to show her feeling and emotion by herself
    Also, please monitor her complication as her medication for over sleeping and non-sleeping
    And if she has something for emergency situation do not hesitate to call us for example this situation that she tried to hurt herself

    Your sincerely

    charge nurse

  16. Ms. Bhavna Sandrine,

    Charged Nurse,

    Palmer Home Care Facility,

    Baltimore.

    03hd January 2018

    Dear Ms. Bhavna,

    RE: Caderina Piper, age 90 years-old

    I am writing to you a discharged letter of Ms. Caderina Piper who has been admitted to our facility as a diagnosis of Post Traumatic Stress Disorder secondary to Chronic anemia, osteoarthritis, and urinary incontinence. However Ms. Piper is mobilizing and independent.

    For your kind reference, she has had a traumatic history back in october,2016 where her home is robbed and discharged to a senior care in eastern Baltimore County. However when she was seen again in March,2017, she Ms. Piper still very emotionally ill but not suicidal. The symptoms of psychotic and severe paranoia continued until November, 2017 where she is has been hospitalized  on a psychiatric unit and improves over 14 days fortunately without antipsychotic drugs. She has been showing good improvement following 1 week of discharged from the hospital and returned to the senior apartment.

    Ms. Piper is on Haloperidol 0.025 – 1.0 mg per day also underwent a cognitive behavioral and exposure therapy.

    It would be great if you could follow the nursing management such as encourage identification ineffective coping mechanisms and consequences and also discuss with patient about her feelings. In addition to that, encourage patient to accept her emotions, develop appropriate support systems for further therapies. Should any unfortunate event happen if she tries to hurt herself or others, do call the emergency number and inform the doctor if she cannot sleep or sleeping too much.

    Thank you.

    Yours Sincerely,

    Imelda taunek

    Charge Nurse.

  17. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    Dear Ms. Sandrine
    Re: Caderina Piper, aged 90

    I am writing you to refer Mrs. Caderina Piper, a 90-year-old widowed woman, who is discharging today into your care and requires your attention for her overall well-being.

    Mrs. Piper was admitted to Beacham Ambulatory Care Center due to post traumatic stress disorder on 03 January 2018. She has been experiencing hallucinations and severe paranoia since home intrusion by criminals which happened more than a year ago. Since then, she has been moving from one facility to another several times, and placed on psychiatric hospital because of her deteriorating condition. Her symptoms are managed with anti-psychotic medication and treated by cognitive behavioral therapy and exposure therapy.

    Mrs. Piper requires frequent monitoring. She has weak family support, only her nephew who contacts her once a month. Identifying ineffective ways of coping mechanisms and consequences are vital for her ongoing treatment. Providing enough time for her to discuss and express her feelings and acceptance of emotions are encouraged. People surround her should know the emergency number to call if she tries to inflict pain to herself or others, and a doctor should be notified if she suffers from insomnia or excessive sleeping, and compliance to medication regimen is a must.

    I wound be grateful if you could ensure her safety and well being is closely monitored. Thank you very much.

    Yours sincerely,
    Nurse Pinoy

  18. (2nd try)
    Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    03 January 2018

    Dear Ms. Sandrine
    Re: Caderina Piper, aged 90

    I am writing to refer you Mrs. Caderina Piper, a 90-year-old widowed woman, who is discharging today and requires your care due to relapse of her psychotic symptoms.

    Mrs. Piper She was admitted to Beacham Ambulatory Care Center due to post traumatic stress disorder on 03 January 2018. She has been experiencing psychotic symptoms for more than a year, with onset of delusion, and confusion since home intrusion by criminals in October 2016. Over two months, she had improved slowly and placed on senior living building in a community in eastern Baltimore County but then transferred to senior housing unit due to her location preference several months later. In November 2017, she suffered a relapse manifested by hallucinations and severe paranoia. She was placed on psychiatric hospital but able to recover two weeks later without antipsychotic medications.

    Mrs. Piper has chronic pernicious anemia, osteoarthritis, and urinary retention. Although she is independent, she requires frequent monitoring. She has weak family support which only her nephew is able to contact her once a month.

    Today, her symptoms are managed with Haloperidol 0.025-1.0 mg daily and treated by cognitive behavioral and exposure therapy. Enough time to explore her feelings, acceptance of emotions, and identifying ineffective ways of coping mechanisms and consequences are focus on her ongoing treatment. Care givers and people around her should know the emergency number to call if she tries to inflict pain to herself or others, and a doctor should be notified if she suffers from insomnia or excessive sleeping. Compliance to medication regimen is a must.

    I wound be grateful if you could ensure her safety and well-being is closely monitored. Thank you very
    much.

    Yours sincerely,
    Nurse Pinoy

  19. Ms. Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    March 1st 2018

    Patient name :Caderrina Piper
    Age: 90 years

    Dear Bhavna

    I am writing this latter to discharge one of the resident to your facility who’s name is Ms Caderina Piper and she is 90 years old with that I am explaining all the medical and psychological condition in this latter. Ms Piper is a widow and her husband dies as result of respiratory arrest, she had only one relative (her nephew) who talks with her one time a month.

    Resident home was broken in October 2016, due to this all problems she was very distressed ,delusional and confused. She was slowly recover over 2 months and admitted in to a senior living building in community located in eastern Baltimore County. In March of 2017 patient seen in doctor office and at that time also resident was emotionally disturbed. She wants to move to other senior living facility. in November 2017, 9 months after moving to a new facility she was diagnosed with PTSD, paranoia, hallucination and other psychiatric symptoms. Because of this all psychiatric symptoms she was hospitalized in psychiatric unit; without medication her condition is improving day by day.

    In hospital she was diagnosed with PTSD,pernicious anemia, osteoarthritis and urinary incontinence, with that resident is fully functional and independent. Resident was on haloperidol 0.025-1 mg/day and other cognitive therapy.

    It would be appreciate if you follow all medical and nursing management as it was follow in our facility and let her share feeling in your facility. Also please call emergency if resident trying to hurt her self or other.

    please do not hesitate to call us about any queries.

    Thank you
    Charge Nurse
    Beacham Ambulatory Care Center

  20. Charge Nurse
    Palmer Home care facillity
    Baltimore
    03/01/2018
    Dear Ms Bhavna Sandrine
    RE:CADERINA PIPER,90 YEARS OLD
    I am refer Ms Caderina who is diagnosed with PTSD. She is also suffering from anaemia,athritis and urine incontinence for a while now,though she is functional and fully independent.Ms Caderina is set for discharge today and she needs continued care and monitoring.
    In October 2016,her home was broken into, she was robbed and auscalted leaving her very distressed,delusional and confused. These symptoms slowly improved and she was discharged to senior living building in the community after 2 months.
    Ms Caderina was seen again in March 2017 with a hx of depression and being emotionally unstable. She stated that she wanted to new senior housing unit.She acutely developed some pychotic symptoms 9 months post moving into senior housing unit which led to her hospitalisation in a psychiatric unit where she improved after 14 days without any treatment.A week post discharged,she started experiencing pychotic symptoms again and she was sent back to the senior apartment.
    She is currently on haloperidol and she is undergoing cognitive behavioral therapy and exposure therapy as well.
    It would be greatly appreciated if you could provide adequate tine for pt to discuss and explore her feelings and also encourage acceptance of pt’s emotions.Please administer meds as ordered.Please call the Dr if she tries to hurt herself or if she cannot sleep or if she sleeps excessively.
    Do not hesitate to contact me if there are an queries.
    Yours faithfully
    Nurse Sadi

  21. Ms Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility
    Baltimore
    03/01/2018
    Dear Ms Sandrine,
    Re: Ms Caderina Piper, aged 90
    I am writing regarding Ms Piper, who was diagnosed with Post Traumatic Stress Disorder and requires medical and psychological support.
    Ms Piper was highly distressed after the thief incident when she was at home in September 2016. After long term recovery, she was discharged to a senior living building in Baltimore County.
    Ms Piper crying, and emotionally still ill was seen in the office in March 2017. She insisted on moving to another new senior House Unit because of its closeness on the bus route so she could easily get around.
    Ms Piper was very ill after 9 months of moving to a new facility, she was hallucinating about which men and women were in her bad. She was hospitalised in a psychiatric unit for psychotic symptoms and severe paranoia for 14 days and recovered without taking any medication.
    When Ms Piper was at our Ambulatory Care centre, she was encouraged to show and accept her emotions. It was arranged referrals for other therapies. She has got only physically needs her urinary incontinence care. Otherwise, she is fully independent.
    Kindly provide contact emergency service if she attempts to hurt herself and please call the doctor in case of sleeplessness or long sleep.
    Please do not hesitate to contact me if any queries
    Yours sincerely,
    Charge Nurse

  22. Ms Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Fcaility, Baltimore

    Dear Ms Sandrine
    02/10/2018
    Re: Caderina Piper, aged 90

    I am writing for Ms Piper, who is being discharged tomorrow. She still requires a strong psychological support.

    As you know, Ms Piper changed residential accommodations several times due to her delusions. Her psychotic symptoms are always escalating once she returned to her apartment. So, a possible recurrence could be expected.

    Haloperidol (1 mg daily) was prescribed associated with a cognitive behavioral and exposure therapy. Although, psychotic episodes are being reduced, it is strongly recommended ongoing support by encouraging exposure and acceptance of her emotions. Medications must be administered regularly.

    I would highly appreciate if you could call the doctor if she has not a good rest and I strongly recommend you to call the emergency number if she is harmful towards herself and others.
    Please do not hesitate to contact me should you require any further information.

    Yours Sincerely,
    Nurse

  23. Ms Bhavna Sandrine
    Charge Nurse
    Palmer Home Care Facility Baltimore
    03/01/2018
    Dear Ms Sandrine,
    Re: Ms Caderina Piper; aged: 90 years.

    I am writing to refer Ms. Piper who is suffering from an Age-related cluster condition with post Traumatic stress disorder. She requires your specific home nursing care and she needs your psychological support to her. She is being discharged today.

    Initially, She was very distressed, delusional, and confused following her home being broken and robbed which gradually improved after 2months. subsequently, she had developed emotional distress about her new home.

    presently, she has been suffering from acute psychotic symptoms with severe paranoia and hallucination regarding men’s and women’s voices due to this she was admitted to the psychiatric ward. she shows improvement in her condition without antipsychotic medication.

    During her hospitalization, she was started with CBT and exposure therapy. she was encouraged to find out her ineffective coping mechanisms and consequences. provided adequate time for her to expose her feelings and emotions at a time and encouraged her to accept her emotions herself. she was arranged participated in support systems and further therapies. her medication was administered as per schedule (Haloperidol 00.25).

    It would be greatly appreciated if you could monitor her sleeping pattern and if any discomfort you noticed please contact a doctor immediately. please monitor if she tries to hurt herself and others kindly contact the emergency number.

    please note, that the doctor and contact number details are attached to this letter.

    If you have any queries related to her condition pleases feel free to contact me.

    Yours Sincerely,
    Nurse.

    It would be

  24. Ms. Bhavna Sandrine,
    Charge Nurse
    Palmer Home Care Facility
    Baltimore

    3rd of January, 2018

    Dear Ms. Bhavna,
    Re: Caderina Piper, 90 year old

    I am writing to refer Ms. Piper, a 90-year old widowed under your facility. She needs your continued medical and psychological treatment. She is set for discharge today.

    She has quiet a long medical history. She is suffering from Post Traumatic Disorder following the robbery from her home on October of 2016. It caused traumatic experience which results to her being distressed, delusional and confused. She’s been very depressed since then. It was on November, 2019 that her mental and psychological capacity regressed or worsens. She shows psychotic symptoms with severe paranoia and hallucinations. She was treated and improve after 14 days but her symptoms reoccur.

    She was admitted to our care center for her PTSD and her chronic conditions. She was prescribed Haloperidol 0.025 – 1.0mg to be taken daily. She is undergoing cognitive behavioral and exposure therapy. She was encouraged to open up her feelings and introduced to some coping mechanisms.

    In regards to above information, I would greatly appreciate if you continue her medical and psychological needs. Kindly also be informed that she has difficulty sleeping and sometimes sleep more than required. In this case, kindly contact the Doctor for advice and call emergency for any dangerous act of patient.

    Yours Truly,
    RPB
    Charge Nurse

  25. Ms. Bhavna Sandrine
    Charge Nurse
    palmer Home Care Facility
    Baltimore

    03/01/2018

    Dear Ms. Bhavna,
    Re: Caderina Piper, 90 year-old

    I am writing to refer Ms. Piper, a 90-year old widowed woman under your facility. She needs your continued medical and psychological interventions. She is set for discharged today.

    She is suffering from Post Traumatic Disorder following the robbery in her home on October of 2016. It cause traumatic experience which results for her being distressed, delusional and confused. She’s been very depressed since then. It was on November of 2019 that her mental and psychological condition regressed or worsens showing psychotic symptoms with sever paranoia and hallucinations. She was treated without psychotic drug and got better after 14 days but reoccur after 1 week of discharged.

    She was admitted in the facility for her PTSD and chronic conditions. She was prescribed Haloperidol to be taken daily. She’s been doing well and undergoing cognitive behavioral and exposure therapy. She was encouraged to be open about her emotions and advise some coping mechanisms to cope with her feelings.

    In regards to above information, I would greatly appreciate if you can continue her medical and psychological needs. Kindly also be informed that she has difficulty sleeping or sometimes sleeps more that required. In such cases, kindly contact her Doctor for an advice and call emergency for any disturbance or dangerous actions of the patient.

    Sincerely Yours,
    RPB
    Charge Nurse

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