Chapter 23, Problem 1RP

Summary Introduction

To discuss:

How do you think you would respond in a similar situation? Why?

Case summary:

Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.

Explanation of Solution

In a similar situation, the nursing student could first determine the patient’s needs for independence and safety. The nursing student then would work with the social services in order to investigate the possible community support resources that are available for this patient where the patient could maintain her independence. The nursing student then might suggest certain options that are suitable to Mrs. P. The patient’s wish for being independent and the nursing student’s concern on the patient’s safety might be fulfilled by doing so.

Summary Introduction

To discuss:

What does this tell about yourself and about the adequacy of your skills for professional practice?

Case summary:

Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.

Explanation of Solution

The nursing student was found to be still in the learning phase and developing the skills for professional practice. On the basis of the answer provided in the similar situation, the nursing student seems to have adequate skills for the professional practice.

Summary Introduction

To discuss:

Can you think of other ways to respond?

Case summary:

Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.

Explanation of Solution

The nursing student could seek counseling from the instructor. The nursing student could explore other resources and obligations of the caregivers to determine the realistic options for this patient.

Summary Introduction

To discuss:

What could the nursing student have done differently?

Case summary:

Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.

Explanation of Solution

The nursing student might have convinced Mrs. P to choose any of the options without disturbing her autonomy. The nursing student might explain the disadvantages of being alone. The nursing student might suggest more options to the patient rather than the retirement community or long-term care facility.

Summary Introduction

To discuss:

What skills, knowledge, and attitude do you need to develop to continuously improve quality and safety when caring for patients like Mrs. P?

Case summary:

Mrs. P is a single, 88-year-old woman, was hospitalized for cardiac problems. She has been in her beginning of dementia. She lives alone in a small home along with her cats. When she was ordered for the discharge, the nursing student worried about Mrs. P’s ability to live safely on her own. The nursing student suggested her about moving to a retirement community or long-term care facility. But Mrs. P refused those options. The nursing student was worried about her safety and reported to the charge nurse. The charge nurse replied that we can do nothing if the patient is not willing to explore the other options.

Explanation of Solution

The nursing student should develop the knowledge of physiologic changes that are associated with aging. This could help in developing an appropriate plan care for this patient after her discharge. The nursing student should gain information about all the possible community resources that are available for this kind of patients. The nursing student should improve her interpersonal communication skills and increase knowledge in order to support services for aging adults.