Case Study Review Essays - Health, Confidentiality, Secrecy, Source

Case Study Review Essays - Health, Confidentiality, Secrecy, Source Case Study Review Laura Rubio BSHS/335 March 30, 2015 Stephanie Chupein Case Study Review In case study 9, the case talks about Physician Access to Information as a Noncustodial Parent. In this case it talks about a 14-year-old boy by the name of Rajiv who was recently treated in the Emergency Department. Rajiv's mother has sole custody of him, and Dr. Singh who is his father does not have visitation rights of him. Due to circumstances of his divorce, Rajiv's mother was able to provide documentation for inclusion in his health records stating that under no circumstances would Dr. Singh would be allowed to access Rajiv's health information. Rajiv's father Dr. Singh ran into Mrs. Singh's neighbor in the grocery store, and that is when the neighbor had asked about his recovery. That is when Dr. Singh said that he was unaware of any issues concerning Rajiv's health, prompting the neighbor Mr. Smith to fill him in on the details. Mr. Smith was unaware of the custody arrangements and details of the divorce. The next morning, Dr. Singh went to the Health Information Services department requesting a copy of his son's records for review. Thanks to talking with the neighbor, Dr. Singh was able to provide a date and circumstances of his son's medical treatment to the Release of Information clerk pulled Rajiv's chart, as she was getting ready to copy the record she noticed a note prohibiting Dr. Singh from accessing Rajiv's records. Dr. Singh who knew that this clerk did not like confrontation with physicians, he simply told her that he was trying to assist Rajiv's mother in getting a copy of his records to take to a specialist that was she did not have to come and get them herself. Even after Dr. Singh telling her that the clerk, defended the confidential nature of Rajiv's records and she refused to copy the records. Dr. Singh then became loud and abrupt with the file clerk to the point that Jane, the Director of Health Information Services, came out of her office to determine what the pr oblem was. Jane reminded Dr. Singh of the confidential nature of all patient health records and the privacy and security issues presented through the Health Information Portability and Accountability Act. Dr. Singh then said that he understood and respected that regulations must be followed. About a half hour later, Dr. Singh presented to the Physician Record Assistant's desk. This is when he requested his incomplete records so that he could sign and dictate outstanding reports. He also requested for them to pull Rajiv Jones' chart for him to review. She had some difficulty locating Rajiv's chart, she went to other areas of the Health Information Services department to see if anybody else had the chart. When the Release of Information Clerk was approached about the record, she was informed the Physician Record Assistant that Dr. Singh was not allowed access to Rajiv's records. She then informed Dr. Singh that she could not give him Rajiv's chart, and if he has any questions, he should talk with Jane. Then he apologized for any inconvenience, completed his incomplete records, and then went to the nursing units to do his rounds. That is where he has developed a relationship of respect with the nurses on the unit and made another attempt at requesting his son's records while on his morning rounds. He had asked Betty, a nurse on the orthopedic unit, if she could call and have the chart sent up for him, she promptly called Health Information Services, simply stating that a physician needs the chart. That is when Betty was asked which doctor was requesting the chart and Betty said that it was Dr. Singh. She was then told that he was not able to have access to the records. That is when Betty responded by demanding that if a physician requests records, that physician's intentions should not be questioned. The Release of Information Clerk finally transferred Betty to Jane, who continued to protect the confidentiality of the records. Finally Dr. Singh went to visit the Chief Executive Officer (CEO) of the facility Charles to make arrangements for their weekly golfing outing. Dr. Singh reported that he was having problems getting

Using Spanish Direct and Indirect Object Pronouns

Using Spanish Direct and Indirect Object Pronouns Perhaps the most difficult aspect of grammar for most Spanish students when learning how to use pronouns is learning how to use and distinguish between direct-object and indirect-object pronouns. Direct-object and indirect-object pronouns have similar functions, and the pronouns themselves are the same in the first-person and second-person familiar forms. Direct vs. Indirect Objects First of all, some definition of terms is in order. Direct-object pronouns are those pronouns that represent the nouns directly acted upon by the verb. Indirect-object pronouns stand for the noun that is the recipient of the verbs action. In both English and Spanish, a verb may have no object (e.g., I live, vivo), a direct object only (e.g., I killed the fly, matà © la mosca), or both direct and indirect objects (e.g., I gave her the ring, le di el anillo). The construction of an indirect object without a direct object isnt used in English, but it can be done in Spanish (e.g., le es difà ­cil, it is difficult for him.) In the third example, the direct object of the verb is the ring (el anillo), because it is what was given. The indirect object is her, (or le) because the person is the recipient of the giving. Another way of looking at indirect objects in Spanish is that they could be replaced by a prepositional pronoun or sometimes para prepositional pronoun. In the example sentence, we could say di el anillo a ella and mean the same thing (just as we could say in English, I gave the ring to her). In Spanish, unlike English, a noun cant be an indirect object; it must be used as the object of a preposition. For example, we could say I gave Sally the ring in English, but in Spanish the preposition a is needed, le di el anillo a Sally. As in this example, it is common, although not strictly required, to include both the pronoun le and the named indirect object.) Similarly, note also that in Spanish the indirect object pronoun must refer to a person or animal. In English, we use the same pronouns for both direct and indirect objects. In Spanish, both types of object pronouns are the same except in the third person. The third-person singular direct object pronouns are lo (masculine) and la (feminine), while in the plural, they are los and las. But the indirect object pronouns are le and les in the singular and the plural, respectively. No distinction is made according to gender. The other object pronouns in Spanish are me (first-person singular), te (second-person familiar singular), nos (first-person plural) and os (second-person familiar plural). Following in chart form are the object pronouns in Spanish. The direct objects are shown in the second and third columns, the indirect objects in the fourth and fifth columns. me me Ella me ve (she sees me). me Ella me dio el dinero (she gave me the money). you (familiar) te Ella te ve. te Ella te dio el dinero. him, her, it, you (formal) lo (masculine)la (feminine) Ella lo/la ve. le Ella le dio el dinero. us nos Ella nos ve. nos Ella nos dio el dinero. you (familiar plural) os Ella os ve. os Ella os dio el dinero. them, you (plural formal) los (masculine)las (feminine) Ella los/las ve. les Ella les dio el dinero. More About Using Object Pronouns Here are some other details of using these pronouns you should know: El leà ­smo: In some parts of Spain, le and les are used as direct-object pronouns to refer to masculine human beings instead of lo and los, respectively. Youre not likely to run into this usage, known as el leà ­smo, in Latin America. Se: To avoid alliteration, when le or les as an indirect-object pronoun precedes the direct-object pronoun lo, los, la or las, se is used instead of le or les. Quiero drselo, I want to give it to him (or her or you). Se lo darà ©, I will give it to him (or her or you). Placement of object pronouns after verbs: Object pronouns are placed after infinitives (the unconjugated form of the verb that ends in -ar, -er or -ir), gerunds (the form of the verb that ends in -ando or -endo, generally equivalent to the -ing ending in English), and the affirmative imperative. Quiero abrirla, I want to open it. No estoy abrià ©ndola, I am not opening it. brela, open it. Note that where the pronunciation requires it, a written accent needs to be added to the verb. Placement of object pronouns before verbs: Object pronouns are placed before verb forms except those listed above, in other words, before nearly all the conjugated forms. Quiero que la abras, I want you to open it. No la abro, I am not opening it. No la abras, dont open it. Order of object pronouns: When both direct-object and indirect-object pronouns are objects of the same verb, the indirect object comes before the direct object. Me lo dar, he will give it to me. Quiero drtelo, I want to give it to you. Obviously, there are quite a few rules to learn! But youll find as you read and listen to Spanish that the rules will become a natural part of your understanding of the language.