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Collaborative Nursing - Case Study Example

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While all patients are deserving of empathy to one degree or another, the case of Mrs. P is particularly ripe for a caring nurse. The interpersonal process will be particularly crucial in her case. For the past nine years, she has been a paraplegic, as a result of a spinal compression…
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Download file to see previous pages Up until now, she has had no support from the social service system, as she did not feel it to be necessary.
It could easily be difficult to get Mrs. P to accept the assistance of social services. Her history shows a dogged desire to live as independently as possible, despite the fact that her medical conditions have made her life extremely uncomfortable. At her age, she may well feel that she can lead an autonomous existence, and that any worsening of her current symptoms is only a temporary annoyance. Tolerating them for a short time, in her mind, might well be preferable to accepting the intrusion of daily skilled nursing visits, confinement in an assisted living facility, or even more intrusive medical care.
In community nursing, there are a number of models that can be used in a situation like this. For a model to work for Mrs. P, it must take into consideration the realization that accepting the intrusions of extended medical care will rob the patient of a great deal of dignity, as far as preserving the idea of autonomy in society. And so any nursing professional will have to be sensitive to Mrs. P's perceived needs, and treat her as a stakeholder in any discussion about her medical care. Also, given the diverse nature of Mrs. P's conditions, this is a case that will require significant interaction among the various care disciplines. Depending on her level of inactivity, a tissue viability nurse could be needed, as could a dietitian. Occupational and physical therapists should also be consulted, to discuss Mrs. P's ongoing needs. Psychiatric referrals could also be needed, if Mrs. P should slip into depression as a result of her worsening physical condition. If members of Mrs. P's care team do not interact thoroughly, it would be easy for one member of her team to make mistakes that would affect the others' ability to find positive solutions for Mrs. P's conditions. Mrs. P's daughter should also be consulted, not only because she has spent such considerable time and energy helping to care for her mother in her degraded physical condition, but because if Mrs. P's daughter is comfortable with the recommendations of the care team, then she will be able to sell her mother on those recommendations, and make the job of Mrs. P's medical team even easier. One model that would be suitable for this case would be the Roper-Logan-Tierney.
The Roper-Logan-Tierney model of nursing care has two primary tenets. The first is its basis on the activities of daily living. This model asserts that there are twelve activities that comprise one's daily existence: maintaining a safe environment, communicating, breathing, eating/drinking, eliminating waste, washing/dressing, regulating one's temperature, moving, work/play, expressing sexuality, sleeping, and dying (Roper, Logan, Tierney 1980, p. 24). The second is the idea of a life span continuum, where in one begins at birth in a state of complete dependence, progresses to a state of complete independence, and then regresses to complete dependence at some point before death (Roper, Logan, Tierney 1980, p. 27).
After assessment, it became clear that just about the only activity of daily life that Mrs. P's medical condition did not threaten was the last one (dying). While Mrs. P's daughter was doing the best ...Download file to see next pagesRead More
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