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The purpose of this assessment is for you to apply the concepts and information in this subject to a specific case study to demonstrate your understanding of mindful communication with colleagues, the patient and family or significant others (including selfcare), the scope of practice of a registered nurse, including interprofessional and intraprofessional collaboration.
Complete this assessment task by reviewing the case scenario on the Subject Interact site and addressing the following using an essay format:
1. Based on the case scenario, describe specific mindfulness techniques a nurse can employ to establish a therapeutic relationship with the patient and their family or significant others.
2. Based on the patient's condition in the case scenario, describe interventions a registered nurse could perform within their scope of practice and the actions they should take when a situation or intervention falls outside their scope of practice.
3. Describe the importance of inter-professional collaboration in improving patient outcomes and preventing errors in healthcare delivery, using examples from the case scenario.
Mr. George Anderson is a 65-year-old man with advanced amyotrophic lateral sclerosis (ALS). His illness is now at stage 3, characterized by severe muscle weakness, limited mobility, and difficulty swallowing. He is being fed via a PEG (percutaneous endoscopic gastrostomy) tube, and his current medications include Riluzole and Edaravone. The hospital-in-the-home (HIH) team, specialising in palliative care services, has cared for him throughout his illness. Two months ago, George and Monica, his wife, decided to opt for palliative care services. At their request, Chelsea, a registered nurse (RN) with whom they had built a strong rapport, was assigned as their primary nurse, coordinating with the rest of the HIH team. Chelsea assisted George and Monica in developing an advanced care plan (ACP) along with the team's specialist palliative care doctor and social worker. The ACP is designed to meet the following goals:
To ensure these goals are met, the team has outlined a plan which involves regular home visits, spiritual support arranged through their local minister, and a rotating schedule of visits from family and friends. A 24/7 on-call nurse has also been assigned to ensure rapid response to any emergent issues. Two days ago, another registered nurse and an assistant in nursing made a joint home visit. They found George awake and aware but lying in bed. Despite being nonverbal due to his advanced ALS, he effectively communicated his needs and comfort level through a prearranged eye-blinking system.
During the visit, the team noticed that George's urine output was low and concentrated, indicating possible dehydration. The team promptly increased his fluid supply via the PEG tube and planned to monitor his condition closely. The same visit also revealed that Monica had experienced a fall and was in severe pain. Upon assessment, the RN suspected a possible fracture. As a result, emergency services were called, and Monica was transported to the hospital.
During her absence, temporary care for George was arranged with a home care agency, ensuring continuous care and support. The care plan for George involves regular assessments and continuous monitoring of his symptoms. The team will also reassess Monica's capability to participate in George's care upon her recovery from the fall. A dedicated psychologist in the team provides regular psychological support for both George and Monica.
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