Please both attachments one is including the instructions and the other the peer review writting.
Respond to peers with the following: Read another student’s progress note and assume that you are a PMHNP who will see this patient in an outpatient practice for follow up. Is there anything that wasn’t clear in the note that you would like to ask your NP colleague? Also, assume the patient isn’t tolerating the medication when you see them in follow up. Identify an alternative medication that would be appropriate and why you would choose it. Please support your writing with at least one peer review journal.
Name:
R.F.
Client level of care at time of discharge: Outpatient
Admission Date: 08/05/2022
Date of Discharge: 01/25/2023
Type of Discharge (Pick one):
Collaborative Discharge: The ASO/CS, Employment Specialist and Client all agree that the services are no longer medically necessary, and the client has successfully completed the program.
Individuals Discontinuation of Services: The client has decided to discontinue services prior to a planned collaborative discharge.
Program Recommendation to Discontinue Services: Due to client’s actions or request, services are no longer appropriate as determined by the Employment Specialist and Program Director.
Psychiatric History:
|
Major depressive disorder, recurrent, mild [ICD-10: F33.0], [ICD-9: 296.31], [SNOMED: 40379007] |
|
Primary insomnia [ICD-10: F51.01], [ICD-9: 307.42], [SNOMED: 3972004] |
|
Generalized anxiety disorder [ICD-10: F41.1], [ICD-9: 300.02], [SNOMED: 21897009] |
Summary of reason for discharge: Effective immediately, and as per the client’s request, no further psychiatric follow ups or medication management services will be provided through this office/ provider.
Discharge Assessment: At the time of discharge, the patient is alert and fully oriented. He denies any suicidal or homicidal ideation.
Recommendations/referrals for continued treatment and community supports: Patient should seek another outpatient clinic that can continue following him. Patient advised to call my office or return to the emergency department if he begins to feel overwhelmed, depressed and or suicidal again. He is advised to see Dr. H for psychological counseling. Dietary counseling advised as well. Patient advised to seek outpatient therapy for continued support.
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