Analysis of a case study using the Caritas Process and Clinical Reasoning Cycle

You are the nurse caring for Shawn on the morning shift.

Shawn Bolton is a 25 year old male who self presented to ED with fevers (temp of 39oC). He has an infected abscess on his left arm from injecting heroin. He has been admitted to your ward for observation and prescribed IV antibiotics.

Shawn was released from prison six week ago for a drug related offence. He was released without accommodation, support or money and has been sleeping rough.

Due to Shawn’s drug use and criminal history, some nurses on your ward are reluctant to care for Shawn. One nurse said they hope he discharges himself so someone more deserving can have his bed.

The handover from your night shift colleague said Shawn didn’t sleep at all last night. He’s highly agitated, complaining of severe stomach cramps, demanding pain relief and wants a cigarette.

Your colleague said Shawn swore when told he was only charted paracetamol for his pain and the hospital had a no smoking policy. Shawn was told his behaviour was inappropriate and your colleague walked out the room to let him calm down. Staff on your ward have been told to limit contact with him because of his drug seeking behaviour and criminal record. Security has been notified and will monitor his behaviour. Although you are not sure what’s happening with Shawn, based on the handover, you are concerned about heroin withdrawal and his risk of endocarditis.

(The following shortened clinical scenario is taken from Goodhew, M., & Robinson, T. (2023). Caring for a person with substance dependence and complex post-traumatic distress syndrome. In T. Levett-Jones

(Ed.), Clinical reasoning: learning to think like a nurse (3rd ed., pp.

190-191). Pearson Australia.

From the case scenario provided above, please answer the following questions:

1. Identify the key aspects of the clinical scenario

2. Describe the caritas processes and discuss where and how they relate to the clinical reasoning cycle in the scenario

3. Describe how the caritas processes and clinical reasoning cycle could be used to achieve solutions to address the care needs for Shawn