Highlights
Task:
Scenario One: The perspective of patient/service user (20 marks)
Kate (25) is diagnosed with imminent renal failure. She is very upset by this, but thus far there are no clear physically disabling symptoms. However, she describes herself as being in a crisis, although she goes to work more-or-less as normal. She is on the waiting list for a kidney transplant, but not at all sure that she will get one. Her father and another relative died of this congenital condition. Kate’s significant upset is exacerbated by what she considers exceedingly uncaring responses to her situation by health care professionals.
Discipline/profession specific aspects:
General/Children’s Nursing: Kate is very worried and is hoping to receive advice on a healthy lifestyle from a well-informed nurse. She says she needs support from someone within the healthcare system she can trust.
Mental Health Nursing: Kate is referred to the Community Mental Health Team for assessment by her GP because she is reporting significant low mood. Her GP is reluctant to prescribe anti-depressants. On arrival for her appointment Kate says ‘I am not crazy!’
Intellectual Disability Nursing: Kate has a mild intellectual disability. She lives in supported housing. She says she does not really understand much of the information provided by health professionals. She is afraid because a friend has told her that she won’t receive the transplant because of her disability.
Midwifery: Kate is pregnant. Her boyfriend is very happy with this. Nonetheless, she is unsure how she feels about the pregnancy and whether she should have a baby considering her health condition.
TASK I: In writing respond to Scenario 1 (400w). Include the following:
Provide an analysis of issues in the scenario, taking into consideration bio-psycho-social aspects and applications to practice.
Your response
Scenario Two:Large Healthcare Centre(20 marks)
Since new management took over, things are not the same. Cost cutting has led to layoffs, increased workload, and a new system of longer shifts has been introduced. Average absence from work due to illness have doubled in the last few months. Many staff complain about the changes. Building activities on the site generate noise and dust. A few days ago, you heard that the department you work in is threatened with closure. Nobody knows exactly what is going to happen. You are worried about the care you can provide. Relationships between you and your colleagues are tense. Due to these problems, the running of all units, including your own, is affected. Several of your colleagues have left and found other employment. Patients/service users are complaining. What can be done to maintain care levels?
There are no discipline/profession specific aspects in the scenario. However, discussion and analysis may include discipline specific elements.
TASK II: In writing respond to Scenario 2 (600w). Include the following:
Provide a critical analysis of issues in the scenario, taking into consideration the bio-psycho-social aspects and theory/evidence-based interventions.
Your response
Scenario Three: All in the family(crisis)(30 marks)
The Murphy family consists of two parents John (55) and Ciara (49). John runs a plumbing company. Ciara is running the household. They have five children. Three female: Mary (24), Christina (21), and Breda (12) and two male: James (26) and Tom (19). They live in Tallaght.
The oldest son James has emigrated. Mary the second child lives with her family and two children in the same housing estate. Mary’s family’s laundry is done in the big machine in John and Ciara’s house. The second daughter Christina is a student and still lives at home. The fourth child Tom has a moderate intellectual disability. He has also been living at home, but this is becoming increasingly difficult. He is on the waiting list for an assisted living project not far away. The youngest girl Breda is still in primary school. She has a variety of health problems, including asthma. Some of it appears stress related. She has missed school on more than twenty occasions this year and as a result has received a letter from the School indicating that this will have to change. Mother Ciara has been struggling with diabetes for a few years now. Lately she is showing signs of low mood. She has made reference in passing to wanting to ‘escape from it all’ but was vague about what this meant.
John’s mother Ann is 83 and like Mary lives close by. Her husband is in a nursing home and she relies on John and Ciara to drive her to see him and support her in her own house. However, John and Ciara are unsure how long they can continue with this support given their circumstances and are concerned about Ann’s future.
In the last two weeks the family is in crisis as a result of three sudden events. The first is that Christina has told the family that she is three months pregnant. She wants to have the baby. While she knows who the father is, she does not want him involved. The rest of the family has considerable misgivings about this. The second is that John has had a heart attack and has been in the cardiac care unit of Tallaght University Hospital. While he is doing rather well and conversations about rehabilitation have been started, his wife Ciara has had what she describes as a nervous breakdown (third event). She has been admitted to a closed ward after she threatened Breda and Tom and subsequently attempted to take her own life. Accounts of exactly what happened differ.
Discipline/profession specific aspects:
Team discussions within your discipline/profession should focus on the person of interest specific to your discipline/profession, but always within the context of the family, the bio-psycho-social model, and the other significant events.
General Nursing: focus on father John and his mother Ann
Children’s Nursing: focus on Breda;Mental Health Nursing: focus on Ciara;ID Nursing: focus on Tom;Midwifery: focus on Christina
TASK III: In writing respond to Scenario 3 (700w). Include the following:
Analyse the scenario, taking into consideration the bio-psycho-social aspects, and relate to relevant empirical literature on the issues and interventions.
Your response
Scenario Four: Multidisciplinary community care, recovery and rehabilitation (30 marks)
(continuation of Scenario Three)
While matters were very tough for a while, the crisis in the Murphy family seems to have abated. The oldest son James and his wife Adaku have decided to move back to Ireland from Nigeria to help out the family. His company offered him a position in Ireland. He is very busy and away a lot, but Adaku is an important support to the family. She sees to it that Breda goes to school, helps her with homework, and is getting on very well with Tom.
The father, John, has been in a rehabilitation centre for a few weeks, but has expressed that he really wants to return home now. Mother Ciara is receiving anti- depressant medication and has started psychotherapy. According to her psychiatrist she is also ready to be discharged home. Christina is going to have her baby.
Unexpectedly, Grandmother Ann has turned out to be a support to the family. Instead of waiting to be visited, she takes the initiative. She helps out a bit here and there and strategically bought a new and bigger washing machine.
Not everything is hunky dory though. Mary and James have been bickering a lot and Mary and Adaku are not getting along at all. Adaku and James have slept in his parent’s bedroom but could move in with grandmother Ann for the time being once John and Ciara come back home. They are looking for a house.
Discipline/profession specific aspects:
Team discussions within your discipline/profession should focus on the person of interest relevant to your discipline/profession, but always within the context of the family, the bio-psycho-social model, and the other significant events. Include the multi-disciplinary context.
General Nursing: Apply to the father, John and his mother Ann. John is anxious to go back home, but also worried about the support he is going to receive: How should this be addressed? Grandmother Ann’s health is better than before. Can you explain this?
Children’s Nursing: Breda’s asthma has improved. What could be done to maintain these improvements?
Mental Health Nursing: Ciara is protesting that she is not well enough to go back home. Her psychiatrist is adamant that there is no need for her to remain in the hospital. How can you approach this issue?
ID Nursing: The community ID team has been informed that a place for Tom in the assisted living project has become available. Tom could move in in the next month. It can be reached easily by bus. A decision needs to be made soon. Tom is reluctant. What can you do to prepare Tom?
Midwifery: Christina says she feels lost. She wants the baby but in her confused state has neglected herself (appearance, health, social life, etc.) recently. She does not seem to have a clear perspective on how having a baby will change her life?TASK IV: In writing respond to Scenario 4 (800w). Include the following:
Analyse the scenario, taking into consideration the bio-psycho-social aspects, and relate to relevant empirical literature on the issues and interventions.
In addition to your discipline-specific focus, relate to the multi-disciplinary aspects of the scenario.
Your response
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