HLTAMB012 - Communicate in Complex Situations to Support Health Care - Edward Turner Case Study - Nursing Assignment Help

Assignment Task

The Case Study 1 – Part A  
Edward Turner is a 78-year-old gentleman who has lived alone for many years following the  death of his wife. He has one child, a daughter of 32 years who lives in another town (a 5- hour drive away). ‘Ted’ is supported by good friends and neighbours who have taken on  many responsibilities to help him safe, healthy, and in his home.  
Ted is fiercely independent and has learned a lot on new skills since the passing of his wife,  but in the past year his health has deteriorated; with his arthritis and mobility starting to  make home life difficult. Some of his hardship has been reduced by several appliances being  installed in his home to help him mobilise around the house and be safe in the toilet.  Although this has meant that Ted has had to make compromises in his life, the supports  systems have worked well for some months. 
In the past month he has had three falls in and outside of his house causing him only  superficial bruises; but, one fall necessitated a trip to his GP for a sizable skin tear to his shin.  Sadly, this afternoon, Ted’s neighbour arrived to find him on the patio floor with a laceration  to the forehead, a swollen left wrist, and chilled to the bone. Ted’s friend immediately called  the ambulance. 
On arrival at the scene, you find Ted on the patio floor covered with a blanket and his  neighbour by his side. He is agitated, and with a firm voice telling his neighbour to: “leave me  alone…I’ll wait for my daughter to come! More of his neighbours come to see if they can help  and begin to talk about what has happened and Ted appears to become more annoyed and  agitated. You say hello to Ted, but he seems to ignore you. His neighbour says: “his hearing  aid is not in…I’ll go look for it”
Response Questions (Part A) 
1. Considering the information in the Case study notes above, discuss why might this  patient, Ted, might be reluctant to call ‘000’? (dot points or 10-20 words)  
2. Identify and discuss three (3) communication strategies you could use to introduce yourself and begin to develop rapport with Ted, specifically considering he does not  have his hearing aid in? 
3. How ‘could’ you reduce the external interference (noise) in the immediate  environment? 
 You must identify two (2) strategies/actions you might use. (dot points acceptable)  
4. At this moment, would touching Ted seem appropriate? You must provide a justification  for your answer of either yes or no (20 -50 Words). 
5. What other non-verbal communication techniques can be used to reduce Teds distress?  
List a minimum of 3 the non-verbal communication techniques you could use and  discuss how they would likely support reducing ‘stress for the patient. 
AT1.2 Written Response - Case study 
6. Proximity - Personal Space and your interaction with Ted?  
Identify and discuss the four (4) common zones of proximity with regard to the personal  space and your interaction with the patient, Ted. 
Note-all 4 common zones must be identified and the purpose or use of the same  identified. (10-40 words per zone) 
7. Discuss the privacy and confidentiality issues or concerns you need to be aware of  specifically related to interactions by and with Ted’s neighbours (60-100 words)
AT1.2 Written Response - Case study 
The Case Study 1 – Part B 
Ted acknowledges your presence and his neighbour arrives with his hearing aid and Ted  places it in his left ear. He allows you to examine him. Your assessment uncovers: 
Pulse = 110, Reg GSC= 15 Orientated to time, place, and person BP = 98/75 PEARL Swollen left wrist with a “dinner fork’ deformity 
Resp Rate = 24 BGL= 5.1mmol 3cm laceration to left temple – minimal  bleeding 
SaO2= 93% Diaphoretic ECG Rhythm strip = ‘sinus tachycardia’ 
Ted complains of pain to his wrist left which is a ‘throbbing’ pain that he rates as 6/10.  During your assessment Ted appears angry and only gives you short terse answers to your  questions. However, you further ascertain that he has an allergy to iodine, and has not had  major surgery. He is prescribed Non-Steroidal Anti-inflammatory drugs (NSAIDs) for his  arthritis. 
You apply oxygen at 4 L/min by nasal cannula, dress the wound to his head, and immobilize  his left wrist and arm. You then tell Ted of your intention to take him to hospital to be  treated by the doctors and he becomes quite agitated and angry. He tries to stand and says:  “I’m fine! I am not going anywhere until my daughter gets here! Has anyone rang my  daughter?” He kicks the patio chair and then shouts, “I know my rights! I’m not leaving my  house”
AT1.2 Written Response - Case study 
Case Study 1 - Response Questions Part B 
8. Describe and explain the use of three (3) de-escalation measures in this situation that  may assist in reducing Ted’s distress relevant to the case study part 2 of 3) 
9. Read and analyse the following statements and describe (identify) why they would be  considered judgemental and the impact to the patient comprehension or  understanding? That is may it make the patient feel or would it impact on the emotional  response/assumption from the patient. 
a. "Living here is too unsafe. We need to take you to the hospital to get you fixed  and then you will need to find somewhere else to live."  
AT1.2 Written Response - Case study 
b. "Your impaired mobility, secondary to your arthritis, will prohibit normal living.  You need immediate medical interventions and then professional assessment  prior to placement." (min 3 dot points with explanation and/or 20-50 words  minimum) 
c. "I know you're angry about all of this, but it’s no-one else’s fault. We would just  like you to get you into hospital to be treated and have you assessed." (min 3 dot  points with explanation and/or 20-50 words minimum) 
10. For this task you are required to re-construct one of the statements above (a-c) to ensure you reflect communication that encompasses and shows empathy and will  support Ted’s understanding and validate his emotions/feelings.

Case Study 2 – Part A 
Edward Turner is a 78-year-old gentleman who has lived alone for many years following the  death of his wife. He has one child, a daughter of 32 years who lives in another town (a 5- hour drive away). ‘Ted’ is supported by good friends and neighbours who have taken on  many responsibilities to help him stay safe, healthy, and in his home.  
Ted is fiercely independent and has learned a lot of new skills since the passing of his wife,  but in the past year his health has deteriorated; with his arthritis and mobility starting to  make home life difficult. Some of his hardship has been reduced by several appliances being  installed in his home to help him mobilise around the house and be safe in the toilet.  Although this has meant that Ted has had to make compromises in his life, the supports  systems have worked well for some months. 
In the past month he has had three falls in and outside of his house causing him only  superficial bruises; but, one fall necessitated a trip to his GP for a sizable skin tear to his shin.  Sadly, this afternoon, Ted’s neighbour arrived to find him on the patio floor with a laceration  to the forehead, a swollen left wrist, and chilled to the bone. Ted’s friend immediately called  the ambulance. 
On arrival at the scene, you find Ted on the patio floor covered with a blanket and his  neighbour by his side. He is agitated, and with a firm voice telling his neighbour to: “leave  me alone…I’ll wait for my daughter to come! “ 
More of his neighbours come to see if they can help and begin to talk about what has  happened and Ted appears to become more annoyed and agitated. You say hello to Ted, but  he seems to ignore you. His neighbour says: “his hearing aid is not in…I’ll go look for it” 
Ted’s neighbour arrives back and has found his hearing aid and Ted places it in his left ear. He  allows you to examine him. Your assessment findings are as follows: 
Pulse = 110, Reg GSC= 15 Orientated to time, place and person BP = 98/75 PEARL Swollen left wrist with a “dinner fork’ deformity Resp. Rate = 24BGL= 5.1mmol 3cm laceration to left temple – minimal bleeding SaO2= 93% Diaphoretic ECG Rhythm strip = ‘sinus tachycardia’ 
Ted complains of pain to his wrist left which is a ‘throbbing’ pain that he rates as 6/10. During  your assessment Ted appears angry and only gives you short terse answers to your questions.  However, you further ascertain that he has an allergy to iodine, and has not had major surgery. He is prescribed Non-Steroidal Anti-inflammatory drugs (NSAIDs) for his arthritis. 
You administer oxygen for Ted at 4 L/min by nasal cannula, you clean and dress the wound to  his head, and immobilise his left wrist and arm. You offer Ted pain relief, however Ted  fervently refuses, saying: “I’m okay…I can look after myself you know!”  
You tell Ted of your intention to take him to hospital to be treated by the doctors and he  becomes quite agitated and angry. He tries to stand and says: “I’m fine! I am not going  anywhere until my daughter gets here! Has anyone rang my daughter?” He kicks the patio  chair and then shouts, “I know my rights! I’m not leaving my house” you encourage Ted to sit  on a chair and take some breaths. 
Ted sits on the chair and breathes, you perceive that Ted in a calmer state and has the mental  capacity and physical stability to wait for his daughter to call back.  

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