CASE PRESENTATION

By: Tia Lowery

INFORMATION ABOUT
CLIENT
Client was admitted to Scotland Memorial for a gunshot wound.
The staff informed us that he was a readmit that was previously admitted because
of a gunshot wound.
They suspect gang behavior and client has tattoos that indicate he is affiliated
with the gang Sur-13. The tattoo is similar to the one pictured below:

MY ROLE WITH THE CLIENT

At Scotland Memorial social workers are primarily responsible for discharge
planning. The doctors have to write a referral to other facilities and the social
worker will set the patient up with the needed resources.

Social workers, also known as case managers, will also conduct intake
assessments with every patient to assess if there is a need for any further
resources.

INTAKE ASSESSMENTS
A usual assessment will consist of the
following questions:

What is your name?

Do you live at home? If so, do you

If the patient has one find out

which doctor they see and when
they last had an appointment. If

live alone or with family members?

you use and what services do they

provide?

the patient does not have one, we

Do you receive any home health

services? If so, which agency do

Do you have any medical

equipment that you use at home?
This could be anything from a cane,
walker, wheelchair, diabetic
equipment, a hospital bed, or

Who is your primary care provider?

offer to set them up with one.

What pharmacy do you use?

Who is the best person for us to

contact in your family or a friend?

Also, ethnic information can be

gathered in the clients chart
because some get offensive when
asked in person.

THIS CLIENTS ASSESSMENT

I looked through the clients chart and found out that he is an unemployed 22 year old
Hispanic man. He does not have health insurance. During this clients assessment I gathered
the following information:
The clients name is R. Rivera.
When asked about his living arrangements, the client stated that he sometimes lived with

his friends. He said that he goes from place to place just depending on what ever he has
going on.
The client does receive home health. However, it is just temporary and it was for wound care

for his first gunshot wound. He uses Health Keeperz and they come out once a week to make
sure his bandages are okay.

 I asked the client if he had any medical

equipment in his home that he uses. He
informed me that he is diabetic and has
diabetic equipment. However, he stated
that his blood glucose monitor did not
work properly. This is always important
to note because as a diabetic patient he
needs proper equipment. Also, with is
wounds his diabetes needs to be closely
monitored.

The client said that he does have a primary doctor and he had an
appointment last month; however, he wants to change doctors because
to him the doctor does not take the time out to help him with his needs.
His words were, That white man doesnt take time out to really help
people like me just because I dont have insurance. This threw up a red
flag for me. Because given his diabetes and new wounds he needs
careful treatment. I offered to help set him up with a new PCP and he
agreed to have an appointment. At a time like this I have to ask which
location would be better for him and if he will need transportation. He
stated that he would like a PCP in his hometown and that transportation
should not be a issue and if it is he would let us know.

 The client uses Walmart pharmacy.

The client asked why I needed a contact person. I informed him

that we use that information when it comes to discharging the
patient. His contact would be who we would call to help arrange
transportation. After being informed of this, the client did not
want to put down a contact person and said that he would
handle that himself.

CONCEPTUAL FRAMEWORK
During this assessment I have learned that the client does not really have family support and his
living situation is not stable. However, he does always have somewhere to stay. The same goes
with transportation; even though he may not know who will provide transportation he does seem
confident that he will be able to make his doctors appointment. Also, the client seems to know the
importance of receiving proper care due to his diabetes. This assessment follows a needs and
strengths perspective conceptual framework. Since this is the field of medical social work it focuses
on what medical needs the client has. Also, this assessment focuses on the strengths of the client
such as their living arrangements and the other areas discussed during the assessment.

CASE REFLECTION
Going into this case, I was a little bias because of the possible gang affiliation.
Yes, the client had a gang tattoo however, it could had been from a previous
affiliation. Also, when I hear of a gunshot wound victim I automatically think
violence. Yet, I have learned that this is not always the case.
This client did not value the family as do I. When he mentioned never knowing
where he would stay and living with his friends, I seemed to think how could you
not live with your family. However, I have to remember that I do not know this
mans whole life story and what underlying circumstances there may be.

 I am not sure what life experiences have shaped this young man to be the person he is. From the
information I have gathered it would seem that if he is in a gang then this may be due to the lack of
family support. I am not allowed but to gather so much information due to doctors and nurses also
having to provide medical care and the patient being moved to other floors in the hospital.
The doctors wrote a referral for continued home health for the patients wounds.
Wound healing is impaired by diabetes. Research has shown that blood glucose levels can narrow blood
vessels and blood circulation, which is critical to wound healing, are results of diabetes. This patient has
been diagnosed with diabetes mellitus and a gunshot wound (Wound Care Centers, n.d). This could be a
bad combination for this client. This is why this client needs to be sure to continue his home health
visits. Also, it is important that the client find a PCP that he feels comfortable with that way he will not
miss appointments.
I recommended that we find provide information to this client about Robeson County Seats Program.
Also, I inquired about how to find out if the client was gang related. I was told this was not an issue that
we would be concerned with because we were their for his medical needs. However, a referral could be
made if the doctor deemed it necessary.

COMPETENCIES AND PRACTICE

BEHAVIORS

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REFERENCE
Wound Care Centers. (n.d). How diabetes affects wound healing.
Retrieved from: http://www.woundcarecenters.org/article/livingwith-wounds/how-diabetes-affects-wound-healing