Throughout clinical, I had many patient encounters that made me think about community and public health systems. However, one specific encounter I had with a patient in the previous spring semester came to mind when reflecting on health disparities in the community. They were an IV drug user with a diagnosis of discitis which involves inflammation of a portion of the spine. This tends to be a common with IV drug users in which an infected needle can cause inflammation and infection throughout the body. In this patient’s case, the infection spread to a portion of the patient’s spine. While I only interacted with this patient for me a mere 8 hours, I learned a lot about social services and the hospital’s role in helping this patient return home with the goal of staying clean. 

When it came to this patient, there were likely many barriers to getting clean. Whether it was addiction or a lack of income leading to cheaper drug use, there were multiple other factors to take into consideration that were not seen in the hospital setting. This patient belonged to the lower middle class and had an apartment that he shared with their fiancé. The patient also had barriers regarding transportation and financial resources since a lot of their money went to their IV drug use. A key factor I remember regarding this patient was their diet. Since fast food options were cheaper, they tended to eat less healthy options prior to admission. During their stay I noticed they would order significant amounts of food including 3 ice creams per day. This could also be a consideration for social services in which his access to healthy options prior to discharge were not beneficial to the patient’s overall health and well-being.  Finally, was this patient’s hygiene status. Whether it be lack of resources at home or in terms of patient priority, the patient had many abrasions as well as some fungus forming in the folds of the skin. While we addressed this, it is also important to consider that when he was eventually discharged, they may not have the resources to maintain adequate hygiene. Overall, this patient had many barriers preventing them from living a healthier lifestyle, though as health professionals we worked to help this patient so that when they were discharged, these barriers were as minimal as possible if not gone completely. 

Through this experience I learned a lot regarding the importance of involving social work as well as ensuring that post discharge the patient has access to the resources they need long term. Personally, I feel as if the hospital worked well with the patient in terms of ensuring that they had a clean and drug free place to go home to as well as providing them with care and comfort throughout the withdrawal period. What I might have done that I did not see in the patient’s notes was a nutrition consult to work with social services to determine how to access healthier options for this patient. Other than this factor, I feel as if the patient had good support from the hospital, social services, as well as their fiancé when they went home. This patient’s case taught me a lot about community health nursing and how us as nurses can play a major role in a patient’s life post discharge.