Janet is awake, alert, and oriented x 3. Her lung sounds are diminished bilaterally with a non- productive cough noted. She smokes two packs of cigarettes daily for greater than 30 years. (I asked Janet how she obtains the cigarettes or pays for them and she refused to answer). Heart sounds are regular rate and rhythm. She is obese with a large distended abdomen and has moderate edema of her bilateral lower extremities.
Janet states that her psychiatric medications no longer work. She feels that they need to be changed or dosages increased. (Janet, personal communication). Mary, the shelter nurse volunteer, phones Bridgeway to make an appointment for Janet and is told that Janet missed her August 6th scheduled appointment. Mary then
Janet states that her psychiatric medications no longer work. She feels that they need to be changed or dosages increased. (Janet, personal communication). Mary, the shelter nurse volunteer, phones Bridgeway to make an appointment for Janet and is told that Janet missed her August 6th scheduled appointment. Mary then