Community Nurse

Community Health Center

Woodville

25 January 2010

RE: Ms. Monica Osburn, 69 years old

Dear Nurse,

I am referring to your care Ms. Osburn, who is diagnosed with hypertension and
depression. She has been attending our center for over six years now but will require
continued care and management from your facility as she will be moving this month to
Woodville, close to her daughter as the latter requested.

Ms. Osburn has been a hypertensive for 10 years now for which she is taking anti-
hypertensives. She was also diagnosed with depression two years ago and was
prescribed anti-depressants for the said condition. It is worth noting that she has a long
history of drinking alcohol excessively, which is further increased when her anxiety levels
are high. In addition, she has been having difficulties in the administration of her
medications by herself.

It would be greatly appreciated if you could monitor her adherence to her drug regimen.
Kindly also check her alcohol consumption and her compliance to her diet plan. It would
also be beneficial if you could encourage her to join various family and social activities,
including elderly citizens' clubs, voluntary groups, and the like, and please also introduce
her to a medical practitioner in the area upon her move.

If you have any questions, please do not hesitate to contact me.

Yours faithfully,

James B. Reid
Attending Nurse
Newport Community Health Center

WORD COUNT 194

Maternal and Child Health Nurse

Greenville Maternal and Child Health Center
Main Road
Greenville

22 March 2010

RE: Ms Ann Ballard, 22 months old

Ms Christine Ballard, 28 years old

Dear Nurse,

I would like to introduce Ann, who was admitted in our hospital due to second-degree
burns, and her mother, Christine, who is suspected to be depressed. They would need
follow-up care upon Ann's discharge today.

On 16 March, Ann sustained second-degree burns from being accidentally scalded with
hot water on her right trunk and arm, prompting admission. For seven days, her burn
wounds were treated with Silvazine dressings twice daily.

Please also note that that there is reasonable probability that her mother, Christine, is
depressed. She just separated from her husband four months ago and has since been
having financial problems. In addition, she is socially isolated as she lives away from her
parents and has very few friends.

It would be greatly appreciated if you could apply Silvazine dressings to Ann's burn
wounds once a day. Please also monitor Christine's mental state and encourage her to
engage in various local supports, including mothers' groups or activities, local childcare
centers, and others. We have already referred her to our hospital social worker, but an
appointment for her to see a local financial counsellor would also be beneficial.

If you have any questions, please do not hesitate to contact me.

Yours faithfully,

Daniel M. Padilla
Charge Nurse
Children's Hospital

WORD COUNT 186