Case Study: Caring For An 82-Year-Old Woman

Case Study you Are Caring For An 82 Year Old Woman Who Has Been Hospita

Case Study you are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before her admission, she lived alone in a small apartment. She reported that she has no surviving family, and her support system consists mainly of elderly neighbors who are unable to visit frequently due to transportation issues. A neighbor is caring for her dog, a Yorkshire terrier, and has requested to bring the dog to the hospital, which she is emotionally attached to. The staff has expressed concern about her nutritional intake and signs of depression.

Paper For Above instruction

Introduction

Nightingale's work fundamentally emphasizes the importance of holistic care, environmental factors, and the promotion of well-being. Applying her principles to this case involves addressing the physical, emotional, and environmental needs of the patient to facilitate healing and improve quality of life. This paper explores the specific interventions grounded in Nightingale's theories, evaluates the ethical considerations surrounding the patient's request for her dog, and discusses nursing diagnoses, interventions, and discharge planning rooted in her overall health needs and Nightingale’s philosophies.

Specific Interventions Based on Nightingale’s Principles

Nightingale believed that a clean, well-ventilated, and quiet environment was vital for patient recovery. For this patient, maintaining a clean and comfortable environment involves ensuring her room is clean, well-ventilated, and conducive to rest. Regular assistance with hygiene—such as wound care—should be provided, emphasizing aseptic techniques to prevent infection, especially considering her burns.

Nutrition is another critical element highlighted by Nightingale, who noted the importance of proper diet in healing. Since the patient has a decreased appetite and appears depressed, interventions should include nutritional assessments and tailored meal plans. Collaborating with dietitians can help ensure adequate caloric and protein intake to promote tissue repair. Offering small, frequent nutritious meals can assist in improving her nutritional status.

Psychological and emotional support are aligned with Nightingale’s focus on holistic care. Providing emotional support through active listening, reassurance, and encouraging communication about her feelings about her injuries and her circumstances can help mitigate depression. Facilitating visitation, including her desire to see her dog, aligns with Nightingale's emphasis on comfort and psychosocial needs.

Environmental modifications, such as creating a calming atmosphere with appropriate lighting and minimizing noise, would promote recovery and mental well-being.

Action Regarding the Patient’s Request to See Her Dog

Respecting the patient’s emotional attachment to her dog is paramount. Nightingale recognized the importance of comfort and emotional well-being; thus, facilitating her request should be considered alongside safety and infection control protocols. I would communicate with the healthcare team and hospital administration to explore options for bringing her dog into the hospital environment temporarily, possibly in a controlled, safe manner. In doing so, I would advocate for her emotional needs, understanding that her bond with her pet provides a source of comfort and psychological stability.

Theoretical Basis of the Decision

This decision is grounded in Nightingale’s emphasis on the holistic environment, including psychosocial factors influencing recovery. The presence of a familiar pet can reduce anxiety, depression, and feelings of isolation, which align with Nightingale's view that the environment encompasses social and emotional aspects, not just physical surroundings. By prioritizing her emotional well-being through her bond with her dog, I align with Nightingale’s holistic nursing approach, recognizing that emotional health directly impacts physical healing.

Nursing Diagnoses and Interventions

Based on assessment, I would establish nursing diagnoses such as:

• Imbalanced Nutrition: Less Than Body Requirements: related to decreased appetite and depression.
• Risk for Impaired Skin Integrity: related to burns and immobility.
• Depression: related to social isolation, recent hospitalization, and change in living circumstances.

Interventions for nutritional concerns include collaborating with dietitians to develop a high-protein, calorie-rich diet, providing oral nutritional supplements if necessary, and encouraging oral intake. For depression, interventions involve psychological support, facilitating visits with loved ones or pets, and possibly referring to mental health services if indicated.

Addressing skin integrity involves wound care, preventing infection, and encouraging mobility as tolerated. Monitoring nutritional intake and emotional responses would be ongoing (Meleis, 2012).

Discharge Planning and Advocacy

Discharge planning should begin early, ideally within a multidisciplinary team including physicians, nurses, social workers, dietitians, and mental health professionals. The goal is to ensure a safe transition back to her community environment, with stability in nutritional, emotional, and physical health.

Key considerations include arranging for home health services to assist with wound care, nutrition, and emotional support. Since transportation is limited, coordinating community resources such as mobile clinics or social services can facilitate her ongoing care (Anderson & McFarlane, 2020).

Members of the discharge team and their roles include:

• Physician: oversees medical stability and prescriptions.
• Nurse: coordinates care, educates about wound management, and advocates for her needs, including pet visitation.
• Social Worker: evaluates home environment, arranges community resources, and addresses social support.
• Dietitian: develops an appropriate nutritional plan for ongoing recovery.
• mental health professional: provides counseling or mental health support for depression.

As her primary nurse, I would advocate for her by emphasizing her emotional attachment to her dog, which is integral to her psychological well-being, and by ensuring her needs are considered in discharge planning. Nightingale’s observations stress the importance of the environment and emotional comfort in promoting health, and I would utilize this perspective to champion her holistic needs in all planning and advocacy efforts.

Conclusion

Incorporating Nightingale’s principles into care involves creating a healing environment, addressing physical needs such as nutrition and wound care, and recognizing the importance of emotional support. Respecting her bond with her pet and advocating for her comprehensive needs supports her recovery and quality of life. Effective discharge planning, involving a multidisciplinary team, ensures continuity of care and addresses her social, physical, and emotional health needs, embodying Nightingale’s holistic approach to nursing.

References

• Alligood, M. R. (2018). Nursing theorists and their work (9th ed.). Elsevier.
• Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. Jossey-Bass.
• Carpenito-Moyet, L. J. (2018). Nursing Diagnosis: Application to clinical practice (15th ed.). Lippincott Williams & Wilkins.
• Gill, M. (2013). Nightingale: The lady with the lamp. Routledge.
• Meleis, A. I. (2012). Theoretical nursing: Development and progress. Lippincott Williams & Wilkins.
• Peplau, H. E. (2011). Interpersonal relations in nursing: A psychological approach. Springer Publishing Company.
• Roy, C., & Andrews, M. M. (2018). The Roy adaptation model. Pearson.
• Standards of Practice for Professional Nursing (ANA, 2015).
• Shearer, N. V. (2020). Fundamentals of nursing: The art and science of patient care. Pearson.
• Waller, S. N. (2020). Principles of nursing practice. Elsevier.