Using an A+D = A Approach to Nursing Assessment & Performance

By Ava Sammarco

A (Assessment) + D (Documentation) = Action 

Assessment

The basis of nursing care rests on the ability of the nurse to utilize assessment of the patient as the first step of the nursing process (Toney-Butler & Thayer, 2020). The power behind the assessment serves as the foundation for the basis and delivery of care and as such it is important that nurses sharpen and hone their assessment skills daily. We have all been impacted by the current health pandemic and yet, it has never been more important to refocus and dedicate our efforts to this crucial step of the nursing process. 

Assessment data (subjective and objective) is collected and reviewed and within this first step of the nursing process, establishes the framework for delivery of care. Without a proper assessment done in a timely manner, patient care outcomes can be severely affected. Thus, assessment remains the critical foundation of nursing care. 

Documentation

With the completion of assessment, the nurse must use documentation to note findings and convey information leading to a plan of action. The old adage, “if it is not documented, then it is not done”, remains as the cornerstone of ethical/legal principles and nurses should be empowered by their sense of duty, responsibility, and accountability to make sure that their documentation is accurate and within the defined parameters of timeliness (McBride et. al., 2018). Electronic health records (EHRs) have led to the creation of a checklist/templated framework that contains both advantages and disadvantages. 

Advantages relate to the consistency and format of the note whereas the disadvantages relate to the concept that if there isn’t a box or checklist component, nurses may have little experience and/or impetus to create a narrative note. Too often in this electronic age, where technology has taken over the documentation of healthcare practice, the narrative note has gone by the wayside. Nurses should utilize documentation effectively, accurately, and most of all, comprehensively to ensure that nothing is missed on the patients’ health record. 

Action 

Implied in the action statement is the nurses’ inherent duty to function as an advocate for his/her patients who are sick and under their care. Nurses are not merely performers of health-related tasks but rather have demonstrated themselves as part of the frontline heroes of the healthcare profession. Dimino et.al. (2020) suggests that nurses should focus on their ability to utilize their psychological capital (PsyCap) which manifests as HERO levels (hope, efficacy, resilience, and optimism) to be better prepared to face the health pandemic challenges. 

Nursing care is comprehensive containing both qualitative and quantitative measurements and literally, the nurse (at the bedside or functioning at the clinic or in the community) serves as the intermediary for the patient as it relates to healthcare delivery.  Following through on assessments and documentation, the nurse plays a critical role in the planning, implementation, and evaluation of care. The coordinated action of the nurse to function as a member of the interdisciplinary care team is fundamental to improving better health outcomes for patients. 

Let’s do the Math – A + D = A Which Leads to Better Health Outcomes 

So, let’s do the math, so to speak, and make sure that nurses perform their due diligence, by starting out with assessment, followed by documentation, and leading to action. Each step of the process can become somewhat cyclical in nature. Healthcare is not a static interface but rather nurses and all healthcare providers must continuously assess, document, and act and repeat the process until the healthcare issue is resolved and/or healthcare outcome is improved. No longer does the healthcare of the patient exist in isolation and all members of the healthcare interdisciplinary team must be part of the process.  

References:

Dimino, K., Horan, K. M., & Stephenson, C. (2020). Leading our frontline HEROES through times of crisis with a sense of hope, efficacy, resilience, and optimism. Nurse Leader, 18(6), 592–596. https://doi.org/10.1016/j.mnl.2020.05.011

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issue with use of electronic health records. OJIN, 23(1). https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Identifying-and-Addressing-Ethical-Issues-EHR.html

Toney-Butler, T.J. & Thayer, J.M.  [Updated 2020 Jul 10]. Nursing process.  In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499937/


Bio‐ Daryle Wane, Ph.D., APRN, FNP-BC

Daryle Wane, PhD, APRN, FNP-BC has 41 years’ experience in the professional discipline of nursing and 29 years’ experience in higher education and is currently the BSN Program Director of the Bachelor of Science in Nursing Program at Pasco-Hernando State College in New Port Richey, Florida. Dr. Wane has taught nursing classes across the curriculum and designed nursing programs functioning as a subject matter expert and participant member of the Instructional Technology Design team.  

Dr. Wane has also authored several publications in nursing and nutrition and serves as a Peer Reviewer for several journals/organizations as well as being an Academic Editor/Editorial Review Board Member for several medical and nursing journals. Dr. Wane has given several keynote addresses at state, national, and international levels and served as an organizing committee member (2nd Florida Nursing Association (FNA) Nursing Research & Evidenced-Based Practice Nursing Conference in 2016, 2nd National Nursing World (NCW) Conference in Las Vegas in 2017, and the 2nd Global Conference on Nursing & Healthcare in London in 2018.

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  33. Alice Perkins says:

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  34. Jessica Amber says:

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  35. A good day out there! I am Catherine, and I live in NY. I am particularly very grateful to Daniel Meuli Recovery for their timely and reliable services in helping me recover the $62,500 worth of BTC I had lost; thereby saving my business!… I want to use this opportunity to say a big thanks to them again and also let everyone out there who is facing similar or related issues hurriedly reach out to them. Listed below is the medium to contact Daniel Meuli Recovery directly: Danielmeuliweberecovery @ email. com or WhatsApp +39351201352

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  37. Neels Ainar says:

    HOW DID I GET ACCESS TO MY CRYPTOCURRENCY WHEN THE TRADING PLATFORM DID NOT ALLOW ME TO WITHDRAW MY FUNDS I was introduced to a cryptocurrency trading platform smatdec. me. where I invested my entire savings, they didn’t allow me to withdraw my profits or my investment funds even after paying all sorts of ridiculous fees. I’m a disabled veteran and losing my funds to these platforms has caused me all forms of financial distress and depression. I was very lucky to have come across Spyweb Cyber Security Service, which was able to help me recover my crypto after their investigation, they found out the platform was a scam site and was only after my investment funds. Spyweb Cyber Security Service was able to recover all my funds. I’m truly grateful and I highly recommend their services to everyone affected by this scam.
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  38. Ben Pesci says:

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  40. Recovery Intel says:

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  41. Claire says:

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  42. Mr john says:

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  43. Martin Aidan says:

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  44. Sophia Richardson says:

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  45. Harry Garnet says:

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  46. Stormi Kim says:

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  47. Nick Mike says:

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  48. Adam Green says:

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  49. Recovery Intel says:

    ARE YOU A VICTIM OF INVESTMENT OR NFT SCAM? DO YOU WANT TO INVESTIGATE A CHEATING SPOUSE? DO YOU DESIRE CREDIT REPAIR (ALL BUREAUS)? SCHEDULE A MEETING WITH AN ETHICAL HACKER ASAP TO GET STARTED.

    ASOREHACKCORP is a financial regulator, private investigation and funds recovery body. We specialize in cases as regards ETHICAL HACKING, CRYPTOCURRENCY, FAKE INVESTMENT SCHEMES and RECOVERY SCAM. We are also experts in CREDIT REPAIR, we analyze what’s impacting your score.
    All software tools needed to execute RECOVERIES from start to finish are available in stock.
    Kindly NOTE that the available tools does NOT apply to CREDIT FIX.

    Be ALERT to FALSE reviews and testimonies on the internet, the authors and perpetrators unite to form a syndicate.

    Contact our team as soon as you can via the email address below to book a mail meeting with an ethical hacker.
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    Stay Safe out there !

  50. Leilah Abdullahi says:

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  51. linda says:

    linda
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  52. Can scammed money be recovered? Yes through Captain WebGenesis.

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  53. As a victim, I was ripped off when I invested in cryptocurrencies because I got into the wrong hands and had $845,000 in BTC stolen from me. I was about to lose up after hearing that it couldn’t be found or recovered, but fortunately I came across an online post about a recovery specialist named Jeanson James Ancheta wizard. I contacted him and did some work with them just to give it a try. I never thought it would be feasible, but to my greatest amazement, they were able to recover $545,860 of the money that was taken from me. I’ve decided to share this with anyone who might require such a service. Regarding BTC recovery, Jeanson James Ancheta wizard provides an incredible service. Contact him on email:(jeansonjamesanchetawizard62@gmail.com) or WhatsApp number: +447529524472.

  54. The decentralized digital money known as Bitcoin has become very popular in the last few years. However, as cryptocurrencies become more widely used, there is a chance that users will lose access to their money because of device malfunctions, lost passwords, or other unanticipated events. In the realm of Bitcoin recovery, this is where Fayed Hacker Recovery shines as a revolutionary solution. Ah, Bitcoin – the digital gold that everyone’s talking about. It’s no secret that Bitcoin has taken the world by storm, and with its growing popularity comes an increased risk of losing access to your precious funds. But fear not, my friends, for I bring you exciting news. Introducing  Fayed Hacker Recovery , the ultimate game changer when it comes to Bitcoin recovery. The bright lights of the Bitcoin world are  Fayed Hacker Recovery. What distinguishes them from the others? Well, this is where things get exciting, so hold onto your broomsticks.  Fayed Hacker Recovery uses an innovative approach to assist you in getting your lost money back. Having the ability to make your Bitcoins reappear in your digital wallet is like having a magic wand. Quite remarkable, isn’t that right? They don’t possess a crystal ball, but they can follow transactions, analyze blockchain data, and locate your misplaced cash thanks to their state-of-the-art technology. With their track record of successfully recovering lost Bitcoin and their commitment to security and customer satisfaction,  Fayed Hacker Recovery is poised to play a significant role in the future of Bitcoin recovery. They are at the forefront of innovation and are constantly exploring new ways to enhance their services. For your problems with digital currency, it’s like employing Sherlock Holmes. Call Fayed Hacker Recovery via :   (writeus AT fayedhacker DOT tech)    WhatsApp : (+44 7462 203648)   Signal : +1 313_264_2635   Website : http://fayedhacker.tech

  55. HOW TO FIND LOST BITCOIN // CONSULT CAPTAIN WEBGENESIS.

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  57. Stefan Ward says:

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  58. Werner Ehrhardt says:

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  59. Okoh Patience says:

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  60. Isabelle says:

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  62. Mavis Wanczyk says:

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  63. Diego Carreon says:

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  64. mary christina says:

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  65. adalynn nora says:

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  66. Bailey Duarte says:

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  67. RECOVER YOUR STOLEN FUNDS FROM ONLINE SCAMMERS WITH Jeanson James Ancheta wizard COMPANY.
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  68. Bren says:

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  69. Paul Gilles says:

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  73. DANIEL RAY says:

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  76. My journey with Wizard Web Recovery began with skepticism, as I had already been burned once. However, desperate times called for desperate measures. I reached out to them, and from the onset, their professionalism was evident. They took time to understand my situation, reassured me of their expertise, and provided a detailed plan on how they intended to recover my lost Bitcoin. Wizard Web Recovery stands out for several reasons. Firstly, their team comprises highly skilled professionals who specialize in blockchain technology and cyber forensics. This expertise is crucial when dealing with the complexities of cryptocurrency theft. They explained every step of the process to me, ensuring I was well-informed and comfortable with their approach. Communication with Wizard Web Recovery was seamless. They maintained regular updates, keeping me in the loop about the progress they were making. This transparency was something I had not experienced with other firms I had contacted. It built my confidence in their ability to deliver on their promises. Another significant aspect of Wizard Web Recovery is its ethical approach. They operate with integrity, ensuring that every action they take is within legal boundaries. In a field rife with scams and false promises, their commitment to ethical practices is a breath of fresh air. They provided me with all necessary documentation and evidence of their progress, which further reassured me of their legitimacy. The actual recovery process was nothing short of impressive. Wizard Web Recovery used advanced techniques to trace the stolen Bitcoin through the blockchain. They were able to identify the wallets it had been transferred to and worked tirelessly to negotiate the return of my funds. The level of detail and precision they demonstrated was extraordinary. By the end of the process, Wizard Web Recovery had successfully recovered my lost Bitcoin. The relief and gratitude I felt were overwhelming. It was not just about the money but about restoring my faith in the possibility of justice and recovery in the cryptocurrency world. Wizard Web Recovery turned my nightmare into a success story. Their expertise, transparency, ethical approach, and relentless effort make them the best in the business. If you are in a similar situation, do not hesitate to reach out to them. They are proof that amidst the darkness of scams, there are still trustworthy experts dedicated to helping you recover your digital assets.

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  77. Richardson Angie says:

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  78. Maria Grace says:

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  79. Newton Ally says:

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  81. Evelyn Amelia says:

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  82. In the digital age, where cryptocurrencies reign supreme, the loss or theft of these assets can be catastrophic. For many, the idea of recovering stolen cryptocurrency seems like an elusive dream, akin to chasing a mirage in the desert. However, amidst the vast expanse of the internet, there exists a beacon of hope – PRO WIZARD GIlBERT RECOVERY. With a name reminiscent of magical prowess, PRO WIZARD GIlBERT RECOVERY is not merely a mystical concept but a tangible solution to the plight of countless individuals who have fallen victim to cryptocurrency theft. Led by a team of seasoned experts, including the enigmatic Mia Wallace, this agency stands at the forefront of cyber and crypto intelligence, armed with over 14 years of collective experience. At the core of PRO WIZARD GIlBERT RECOVERY’s methodology lies a fusion of cutting-edge technology and human intelligence. Through the adept utilization of Cyber tools, Open Source Intelligence (OSINT), and state-of-the-art Cryptocurrency Tools, they navigate the intricate labyrinth of the digital realm with precision and finesse. However, what truly sets them apart is their unwavering commitment to providing actionable intelligence to their clients. One of the hallmarks of PRO WIZARD GIlBERT RECOVERY is its global reach, with offices scattered across the globe. This expansive network enables them to conduct thorough investigations regardless of geographical boundaries, ensuring that no stone is left unturned in the pursuit of lost cryptocurrency. Whether the assets have been siphoned off to the depths of the dark web or hidden within the recesses of offshore accounts, PRO WIZARD GIlBERT RECOVERY possesses the expertise and tenacity to unravel even the most complex of schemes. But beyond their technical prowess lies a deeper ethos – a dedication to empowering their clients. Unlike other recovery agencies that merely offer false promises, PRO WIZARD GIlBERT RECOVERY operates on a foundation of transparency and integrity. They understand that the journey to reclaiming lost cryptocurrency is fraught with uncertainty, which is why they prioritize clear communication and collaboration every step of the way. Moreover,
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  83. Micheal Tov says:

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  84. Cryptocurrency transactions are shrouded in anonymity and the promise of exponential profits often lures unsuspecting investors, tales of loss and deception are tragically commonplace. My own journey into this digital realm began with optimism and excitement, fueled by the prospect of financial gain. However, it quickly descended into despair when I fell victim to the cunning machinations of a fraudulent crypto investment trading platform. Seduced by their promises of astronomical returns, I entrusted them with a substantial sum of £167,000 worth of Bitcoins, only to realize, too late, that I had been ensnared in a carefully orchestrated scheme. The platform’s facade of legitimacy crumbled before my eyes, leaving me grappling with the harsh reality of my situation—a staggering loss of funds and a profound sense of betrayal. I was consumed by a sense of desperation and helplessness. The fraudulent platform, once responsive and accommodating, suddenly ceased all communication, leaving me adrift in a sea of uncertainty. It was then that I stumbled upon a glimmer of hope—an online post praising Salvage Asset Recovery, a reputable cryptocurrency recovery agent known for their prowess in retrieving lost assets. Intrigued and fueled by a newfound sense of determination, I reached out to them, clinging to the hope that they could offer a lifeline in my darkest hour.

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  85. james smith says:

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  86. Noah Connor says:

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  87. How To Recover Scammed Bitcoin – iBolt Cyber Hacker Help Guide

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  89. Rubbin Josh says:

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  90. Worley Nicole says:

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  91. I almost thought I was going to lose my company and my car, but thank god for the digital hackers of the internet I would have lost it all! I order an ATM card from Digital Hacker for over 200,000 euros! that have a daily limit, that’s amazing!!! Thanks Digital Hacker contact him via; Email;    digitacardhacker@gmail.com OR digitalcardhacker@proton.me what’sapp +33758779954

  92. I’m overwhelmed with gratitude towards Sentry Vantage Hacker for their valuable assistance in recovering the $39,540 I had lost to a crypto scam. This amount was meant for my kids’ school fees, and I was deceived by a fraudster posing as Agent David, who promised me a return of $120,000 but it was all a scam. Thanks to Sentry Vantage Hacker expertise and dedication, I was able to recover not only the initial investment but also the profit I was promised. Their help has taken a huge weight off my shoulders, and I can now provide for my children’s education. I highly recommend Sentry Vantage Hacker to anyone who has fallen victim to crypto scams. They are trustworthy, efficient, and reliable. Thank you, Sentry Vantage Hacker, for their exceptional service.
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  94. What does it mean to be a hero? For me, being a hero is about stepping in when all hope seems lost, taking control when others cannot, and making a difference in someone’s darkest hour. That’s exactly what Folkwin Expert Recovery did for my family when my father, the breadwinner and cornerstone of our lives, had a major stroke at the age of 65.
    My father had always been sharp, focused, and in control of everything—especially when it came to his finances. He had invested early in Bitcoin and built up an impressive portfolio worth $400,000. But after his stroke, everything changed. He lost his ability to manage even the simplest tasks, including operating his Bitcoin wallets or email. It was devastating to watch this once strong, intelligent man now unable to remember the recovery phrases he had so carefully stored.
    As the family gathered around him, hoping for his recovery, the reality set in—he was the only one who knew how to access his cryptocurrency holdings. My father had never shared his recovery phrases, and now with him unable to function cognitively, we were locked out of his wallets. That $400,000 in Bitcoin was our family’s financial security, and without access to it, we were facing a very uncertain future.
    In my desperation, I started searching for help online and came across Folkwin Expert Recovery. They seemed like the lifeline we desperately needed. After explaining our situation—how my father could no longer access his wallets or even remember where his recovery phrases were stored—the team at Folkwin Expert Recovery responded quickly and professionally. Their confidence and calm approach immediately reassured me that we weren’t alone in this struggle.
    The team at Folkwin Expert Recovery worked tirelessly, using their expertise to help trace the digital pathways and regain access to my father’s cryptocurrency wallets. I cannot express the relief I felt when they were able to recover the $400,000 worth of Bitcoin that my father had locked away. It was nothing short of miraculous.
    But more than just recovering our family’s financial future, Folkwin Expert Recovery also became a source of education and empowerment. They showed us how to better manage and secure our digital assets moving forward. Their guidance on storing recovery phrases, using two-factor authentication, and setting up secure backup systems was invaluable, ensuring we would never face a situation like this again.
    This experience taught me what it means to be a hero. Folkwin Expert Recovery stepped in when our family needed them the most, giving us not only financial security but also the peace of mind that comes with knowing our assets are safe. They were the heroes in our time of need, and I am forever grateful for their expertise and compassion.
    Thanks to Folkwin Expert Recovery, my father’s legacy and financial contributions will continue to support our family, even as we navigate this new chapter in our lives. They helped us when we thought all was lost, and I cannot thank them enough for their incredible work. For assistance, CONTACT INFO! (Email): Folkwinexpertrecovery @ tech-center (.)com Or (Telegram): @Folkwin_expert_recovery . God is too faithful to fail,
    Regards,
    Julius D Helene.

  95. Roony Gary says:

    Meeting with Century Web Recovery wasn’t actually easy, i never taught such a great service existed, i read so many couple of article online about crypto recovery and at first i had an in-law who got scammed year, 2021. then i never knew that scammed funds could be recovered until i fell into investment scam last year July, 2023. I lost $861k USD to online investment scam, all document from the FX trading investment company where scam and also their acclaimed legal document with fake stamp, they indeed actually succeeded in fooling me until i got rescued by Century Web Recovery legitimate recovery service best experts, it’s a self owned private individual hacker who is well trained for crypto currency stolen funds recovery service, their service are such an excellent one and also Mr Marvel from Century Web Recovery is such an understanding being as well, i explained to him and he got into the job, firstly you are to know a true recovery hacker by their first approach and their claimed recovery process, Marvel requested for the scammer information when i have it all submitted there where some transaction i didn’t talked about it simply because it was out of my thinking so i couldn’t locate where i save some of the scammer information, they made use of several wallet address, Marvel was able to use the wallet i provided for him to track out other wallet address of which i then attested to and Century Web Recovery research was very right and correct so i trusted them more and proceeded, This recovery process by Century Web Recovery took them 48 hours to get completed and finally i received a bit more than what was scammed from me. Such a honest service deserve to be referred in other to spread global and also encourage those who got scammed to write century@cyberservices.com or website centurywebrecovery.pro WhatsApp: +1 (368)-260-8052

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  97. Stephanie Sally says:

    Hello everyone, I am from Wembley, Britain. I want to write this testimony to tell others and thank Dr. Odunga for what he has done for me. The first 12 years of my marriage I had 5 miscarriages and I was called all sorts of names by my mother-in-law and this made my marriage life very hectic and a burden of sorrow. I contacted Dr. Odunga for help and I will say that he is a very strong and honest man and he indeed helped me solve my problem. I saw his email in a testimony and I contacted him, little did I know it would be the end of all my problems. After 2 days of contact, I received a fertility herb and he told me to use it. The herb worked and my husband even loved me more and bought me expensive things. One afternoon, I went to a nearby hospital and came back home with the positive result of my pregnancy and after 9 months I gave birth to a baby boy. Ever since I contacted Dr. Odunga, my story has been different. I have 3 children at present and I am very happy in my marriage. Please, contact him at odungaspelltemple@outlook.com OR Whats App him +2348167159012 to help you too

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