Today, you were assigned to provide total patient care for Mr. Dixon. He is a 73-year-old male who was admitted for a total knee replacement 2 days ago. Today, the bloody output from Mr. Dixon’s Jackson Pratt drains increased dramatically, and the incision site appears to be reddened, swollen, and hot.

He has required intravenous (IV) pain medication every 3 to 4 hours, which reduces his pain from a level 6 to 8 out of 10 to a group of 2 to 3. He refuses to use his continuous passive motion machine because he says it is too painful. He is also nauseated and refused his lunch today.

His bowel sounds are diminished. Mr. Dixon’s wife is at the bedside and shares with you that the patient does not usually complain, so she is worried that something might be wrong. Mr. Dixon’s surgeon is not expected to see this patient until later this evening, after the close of his private practice.

Directions: for the initial post use ISBAR to prepare your handoff report for the next shift and then share what you have prepared with a peer. Use the tool below.

The ISBAR tool leads to conscious, structured communication by …


You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort, and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in, and make corrections as necessary. Often, having a friend proofread your paper for obvious errors is advantageous. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12-point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. Letting your essay run over the recommended number of pages is better than compressing it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted and double-spaced with a one-inch margin on each page’s top, bottom, and sides. When submitting a hard copy, use white paper and print it out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.