Tracy Stratton

Coordinated and advocated for patients' care.

Required to review patients' charts, and to meet with families and healthcare providers to establish the most suitable course of action.

Remove pertinent logistical burdens from patients to ensure that they are afforded the time and space to focus on their health.

• Conducting intake assessments with patients and families.
• Ensuring that families feel sufficiently equipped and supported.
• Developing individualized treatment plans that account for physical, financial, and other constraints.
• Adjusting treatment protocols, as needed.
• Suggesting and coordinating appropriate follow-up services to promote wellness.
• Ensuring that patients have transport to and from their homes and all pertinent healthcare facilities.
• Meeting with members of healthcare teams to discuss patients' progress, and to deliberate on appropriate care.
• Devising innovative solutions or suggesting appropriate referrals for patients who cannot afford to access treatment.

• Using HCHB on tablet to document patient information and assessments in home environment.
• Accessed and de-accessed port-a-cath; managed and removed picc lines; inserted and removed foleys and suprapubic catheters; assessed and managed all types of wounds; obtained labs via venipuncture or other access devices; managed and educated on ostomies; managed and educated on patients medications; managed and educated patients/caregivers on IV antibiotics.
• Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
• Completed initial assessments of patients and family to determine and address individual home care needs; supervising and case managing LPN; addressed patient care needs, collected vitals, dressed wounds and managed catheters

• Assigned RN visits as member of care team, and was required to supervise patient caseload, including LPN.
• Performed patient comprehensive assessments, as assigned, and collaborated with patient multidisciplinary care team (PT, OT, ST, MSW) and other health care professionals to develop/modify and implement individualized plan of care as per physician orders that ensured quality, proper discharge planning and which achieved desired outcomes and goals.
• Helped to achieve and maintain continuity of patient care by communicating information (for lab results, etc) timely, effectively and systematically with all team members providing care to patient.
• Facilitated interdisciplinary communication and follow-up through care coordination on assigned patients and caseload of patients for duration of their service.
• Completed documentation timely, accurately including OASIS assessments, SOC/Admissions, Recertification, ROC/Resumptions of Care, subsequent visits, supervisory visits, physician orders, and care coordination.
• Regularly communicated patient progress to clinical manager.
• Educated patient/family on diseases/medications as necessary.
• Used HCHB to document patient information and assessments in home environment; see documentation for job 8/2018 to 3/2020.

• Responsible for obtaining and documenting vital signs as ordered.
• Responsible for starting and maintaining patent IV access.
• Document patient assessment, medication, health history and past surgeries; provide direct nursing care to pre and post -operative patients ranging from infant to geriatric in 25 bed unit; perform recovery assessment on patients returning from surgery.
• Obtain, interpret, and communicate appropriate lab tests.
• Communicating between patients, physicians and anesthesiologists to ensure patient comprehension of treatment plans.
• Safely monitor patients, administer medication, provide education to patients and caregivers for discharge instructions with focus on proper use of equipment, safety, infection control, and pain management.
• Make follow up phone calls to see how patients are doing after their surgeries.