Highlights
Overview
Step 1: Identify your allocated clinical scenario
• Students in Group A (starting in February, 2021) will select Clinical scenario.
Step 2: Holistic assessment of the patient
Detail the holistic assessment to determine the patient’s access to, and participation in healthcare using the template provided (300 words).
Step 3: Implementation and evaluation
Select and describe nursing / midwifery actions to prepare the patient for discharge utilising the social justice framework and professional codes and standards to address the social determinants of health (SDH) that impede the access to, and participation in healthcare (300 words).
Shane Case Study
Shane was first diagnosed with diabetes at the age of 20. He has infrequent contact with his GP and has not seen a diabetic educator for several years, as he has “not needed to go to hospital”. Shane has been on Metformin since he was 20 and was started on Actrapid 2 years ago. Shane states that he is confused by his “blood sugar machine” and uses it infrequently. Shane says that he gets his Grandmother, Doreen to do his injections.
Shane lives with Doreen, he is her registered carer. Doreen also has T2DM, in addition to obesity, cardiovascular disease, and Transient ischaemic attacks. Shane’s parents moved back to Western Australia
to take up jobs in the Mining Industry 4 years ago, he has not seen them since.
Shane admits to daily alcohol intake, cigarettes and weekly marijuana use. Shane has a diet incorporating take away foods and energy drinks. Doreen cooks a Sunday roast when she is able. Shane likes to cook cheese toasties.
Shane stays up late and sleeps late into the morning, as has been unemployed for three and a half years since he was released from prison. Shane sparingly attends to activities of daily living but is fully capable.
Shane lives on the outskirts of a regional town and relies on the regional bus service to get into town for shopping. Where he lives there are no dedicated walking or cycling tracks. Shane does not engage in any recreational activities or social activities, but he likes to chat to the people at the corner shop.
Shane dropped out of school at the end of grade 9 and admits to reading difficulties. After leaving school he worked at a nursery for some years. He has a healthcare card which reduces the cost of his medications. Shane has no savings and has credit card debts along with AfterPay debt. Shane does not have private health insurance.
Shane has ongoing financial stress related to unemployment. Shane feels socially isolated and would like to be in a relationship. Shane sounds depressed when he is talking.
Recommendations
Complete an holistic assessment of the patient to determine his social determinants of poor health. Prepare the patient for discharge, encouraging access to, and participation in healthcare.
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