Topic: Case Studies on Nursing Theories
Case study #1 Ms. P and her daughter came into the office for a “checkup.” Ms. P said “I am fine, maybe a little forgetful; I have never been good with names.” Her daughter rolls her eyes and stated “But Mom, you are having a hard time finding my house now” as her eyes tear up. Her daughter has made this appointment for her mother as she has been getting more and more disoriented, forgetful and repetitive. The daughter is concerned that her mother probably should not be driving any longer as she has been having many “fender benders” lately. · Based on the case study, what do you think matters most to Ms. P and her daughter and why? · What can the nurse do to honor Ms. P and her daughter’s concern for her memory? · Create a pattern manifestation that will resonate with Ms. P and her daughter. Case Study #2 The hospice nurse sat with Ann’s husband, Ben. Ann was resting quietly as the increased dosage of IV pain medication gradually reached its therapeutic level. Ben turned his head and slowly turned, looking out the room’s only window. As he glanced up, a small flicker of light caught his breath. It was a shooting star. A tear fell from the corner of his eye and he turned to Ann. The nurse sensed that something significant to Ann and Ben was unfolding. Shuffling to Ann’s bedside, he took her small fragile hand in his. These hands had rocked cradles, burped babies, and groomed the horses she loved to ride. Gently holding her hand, he turned to the nurse. “She would ride like the wind was chasing her.” Looking back to Ann his voice broke; choking back tears “Ann, Ann I saw Jessie…Jessie is calling.” Ben turned “Jessie was our daughter. She died having a baby that was too big. When she died it was a pitch-black night. Cold, so cold, the baby died too, a little boy, named him Abe, Jr. after Jessie’s husband. I took Ann outside so she could cry to God above and there in this dark sky we saw two falling stars…together…just falling. We knew it had to be Jessie and Abe…two angels to light up the night.” Ben turned back as a deep sign escaped from Ann’s lips. A soft smile remained as she joined Jessie and Abe. · Based on this case study how would the nurse actualize Parse’s theory of Human Becoming? · How might Parse’s understanding of transcendence guide the nurse, as Ann’s death became a reality to Ben? · What would be the focus of the nurse as Ann’s body was transitioned to the mortuary? Case Study #3 Mr. O was brought by EMS to the ED with a complaint of increasing shortness of breath. He was extremely tachypneic, but managed to say, “I do not want to be admitted.” Mr. O has been suffering with end-stage cardiomyopathy and is not a heart transplant candidate; he believes he will die and this will be his last hospitalization. Evidently, he is also experiencing GI bleeding. Before he is finished with his ED workup, it is clear that he will need to be admitted. His wife arrives and Mr. O is much more consolable. Medical care has eased his shortness of breath and he is able to state, “Every time I am admitted they will not let my wife stay with me, they send her home.” The nurse calls the ICU before he is officially admitted and advocates for Mr. O that he desires to have his wife with him while hospitalized. The ICU staff is very understanding and makes special arrangements to make his wife comfortable in the ICU room with him. Mr. O agrees and will be admitted. · Based on the case study, what do you think matters most to Mr. O and why? What can the nurse do to honor Mr. O’s request and address his fears? · Recognizing that Mr. O’s illness is only one manifestation of his life, describe a plan of care that explores situational freedom.
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