NURS2004 - Assessment 2 Case Study

Assignment Overview

SCENARIO

You are the registered nurse caring for 16-year-old Emily Rousseau as she has been transferred to an acute bed of the Riverina Tertiary Referral Hospital emergency department. The hospital is situated in a large regional town in New South Wales. Emily appears anxious and distressed as she moves onto the bed. She states, “I’m having trouble breathing and I can’t lie down”. You observe her leaning forward and resting on her arms. Sue - the triage nurse - arrives and drops a series of documents on the table in front of you. She states “Here is my triage. The mother is in the waiting room. She has given me a bunch of reports about her history. I have informed the doctor of her status, and they will arrive shortly.” Sue then returns to the triage desk. Emily states “Please, I am so worried. Can you help me?”

TASK

Review the case documentation that has been provided for the scenario. Identify what actions you would take and develop a plan of care for Emily using the template provided.

Reason for Referral

Emily was referred to the school social worker following concerns raised by teaching staff regarding:

• Increased absenteeism

• Signs of stress

• A recent incident involving possession of a vape on school grounds

Additionally, Emily has reported experiencing bullying from a peer in her year group, though not directly in her academic classes.

Known Social Situation

Emily is a 16-year-old student currently in Year 11. She resides in social housing with her mother, who is the sole parent. The family is experiencing financial hardship, with her mother working two jobs to support the household.

Emily has expressed that the challenges of her home environment contribute to her stress. She does not have contact with her father, as her mother holds sole custody awarded by the Family Court. Emily has also disclosed that her current housing has maintenance issues that are not being addressed by the landlord.

Academic and Extracurricular Engagement

Emily is a high-achieving student with a strong academic record. She is particularly interested in science and aspires to pursue a career as a laboratory scientist. Despite her academic success, she is experiencing significant stress related to her studies and the balancing of responsibilities.

She is actively engaged in extracurricular activities, including:

• Playing soccer for the school team

• Participating in the school band as a trumpet player

These activities are important outlets for Emily, contributing positively to her self-esteem and social engagement.

Psychosocial Concerns

Bullying
Emily has reported ongoing bullying from a peer, which has impacted her emotional wellbeing and sense of safety at school. She is being supported by the wellbeing team, and a playground plan has been put in place to increase visibility of interactions between the students.

Substance Use
Emily was recently found in possession of a vape. She expressed regret and acknowledged that it was a poor decision made under peer pressure. She has since received education and counselling from the school’s Deputy Principal, Mark Sonan.

Stress and Mental Health
Emily has shown signs of emotional distress, including anxiety related to academic performance and social dynamics. While she has not disclosed any self-harm or suicidal ideation, she would benefit from ongoing emotional support.

• Regular meetings with Emily have been organised during the school term.

• She disclosed that she currently accesses outside psychological support for these issues.

Strengths

Emily has several strengths and is a valued member of the school community:

• Demonstrates strong academic motivation and goal orientation

• Maintains positive social connections through extracurricular activities

• Has a strong rapport with several staff members, particularly her science teacher, Raina Al-Fayez

Support Plan

During social work sessions, Emily has been found to be insightful and reflective. She has been connected with the school wellbeing team, and her progress will continue to be monitored and supported.

The school also intends to extend additional support by:

• Offering referrals to family support services

• Offering referrals to housing services if requested

Summary of Assessment Requirements

The assessment required the student to review the case of 16-year-old Emily Rousseau, a high school student experiencing health, social, and psychological challenges. The key tasks were:

• Reviewing the case scenario presented in the hospital and school context.

• Identifying Emily’s needs across health, social, academic, and emotional domains.

• Recognising key risk factors such as bullying, substance use, stress, and socioeconomic hardship.

• Highlighting Emily’s strengths and positive supports.

• Developing a holistic care and support plan that integrates medical, psychological, academic, and social interventions.

The assessment demanded both clinical reasoning (through Emily’s hospital presentation) and social work care planning (through her ongoing school concerns).

Step-by-Step Process Guided by the Academic Mentor

Step 1 – Understanding the Case Scenario

The mentor first encouraged the student to carefully read Emily’s case scenario in the emergency department and correlate it with her background information provided by the school. The focus was on:

• Her presenting symptoms (breathing difficulties, anxiety, distress).

• Past reports of stress, absenteeism, and vaping.

• Family and social circumstances influencing her health.

Mentor’s guidance: Link Emily’s immediate health concerns with her psychosocial background to see the “whole child” rather than isolating issues.

Step 2 – Identifying Key Concerns

The student was guided to list Emily’s challenges under specific headings:

• Medical : acute breathing issues and anxiety.

• Psychosocial : bullying, peer pressure, financial hardship, unstable housing.

• Academic : stress from workload despite high achievement.

• Behavioural : vaping under peer influence.

Mentor’s guidance: Use structured categories (medical, academic, psychosocial) to ensure no area was overlooked.

Step 3 – Recognising Strengths

The mentor reminded the student to highlight Emily’s protective factors, such as:

• Strong academic ability.

• Clear career aspirations.

• Active participation in soccer and school band.

• Supportive relationships with trusted teachers.

Mentor’s guidance: Balance concerns with strengths to show Emily’s resilience and the potential for positive outcomes.

Step 4 – Developing the Plan of Care

The student was encouraged to structure the care plan around:

• Immediate needs : managing breathing difficulty and anxiety at the hospital.

• Ongoing emotional support : counselling, stress management, and continued psychological support.

• School support : wellbeing team interventions, anti-bullying strategies, academic support.

• Family and social services : referral to housing support and financial assistance services.

Mentor’s guidance: Frame the plan in practical, realistic steps aligned with existing support systems (school, hospital, community).

Step 5 – Linking to Learning Objectives

Finally, the mentor helped the student map the case to the assessment’s broader learning objectives:

• Application of holistic care principles.

• Integration of clinical and psychosocial knowledge.

• Development of critical thinking and problem-solving skills.

• Understanding the role of interprofessional collaboration (nurses, teachers, wellbeing staff, family services).

Outcome and Learning Achieved

Through this structured process, the student successfully:

• Demonstrated an ability to review complex case documentation.

• Identified Emily’s multi-layered concerns and strengths.

• Developed a comprehensive support plan addressing health, academic, emotional, and social needs.

• Showed awareness of the importance of collaborative practice in supporting young people.

The exercise strengthened the student’s skills in case analysis, care planning, empathy-driven reasoning, and linking theory to practice, all essential for nursing and social work practice.

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