Community Health Case Study:
Title: A Day in the Life of Nurse Michael
Michael is a dedicated home health nurse in his suburban community, where he visits between 7 to 10 clients daily. On this particular day, he has four clients recovering from hip replacement surgery, three clients recovering from heart surgery, and one client who requires intravenous (IV) antibiotics for an infected wound.
In his roster of clients, Michael pays a special visit to Mrs. T., an 87-year-old white woman who lives alone and is recuperating from triple bypass surgery she underwent a month ago. His goals for this visit are to assess her recovery progress, organize her weekly medication container, and administer an influenza vaccine.
Upon entering Mrs. T.’s modest home, Michael is greeted by a scene of disarray: scattered clothes, dirty dishes with crusted food, and no lights on. Mrs. T. is found lying in bed, watching television, and she confides in Michael that she feels too fatigued to perform any household tasks. Her meals consist of pre-made items like frozen dinners and potato chips because cooking is too exhausting for her. She spends most of her days in bed and hasn’t bathed in a week.
Michael assists Mrs. T. out of bed and aids her in taking a bath. After her bath, he prepares a quick lunch for her and refills her medication box while she eats. Michael encourages Mrs. T. to gradually engage in household chores as a means of strengthening her heart and increasing her energy levels. He reminds her that a stronger heart will lead to improved vitality. Michael also arranges for additional support services for Mrs. T., including a home health aide who will assist with bathing three times a week and Meals-on-Wheels to provide breakfast and lunch. Lastly, he administers the influenza vaccine.
During Michael’s subsequent visit the following week, he observes significant improvement in Mrs. T.’s condition. She expresses gratitude for the help she receives, noting that the home health aide is especially caring, and the Meals-on-Wheels program has boosted her energy, allowing her to maintain her home more effectively.
Questions:
What challenges did Nurse Michael face during his initial visit with Mrs. T. that were reminiscent of the challenges public health nurses (PHNs) faced in the late 1800s?
Comparing the nursing care provided by Nurse Michael with the historical practices of nursing leaders like Mary Breckinridge in the Frontier Nursing Service (FNS), how are they similar, and how do they differ?
How do the types of illnesses experienced by Nurse Michael’s clients differ from the illnesses clients of PHNs in the early 1900s encountered?
Revised Cultural Diversity in the Community Case Study:
Title: Cultural Competence in Health-Promotion Education
Nurse Betty, who is of a different cultural background, is tasked with teaching a health-promotion class to a group of Hispanic migrant workers. This is her first interaction with people from Hispanic culture. While Nurse Betty possesses some knowledge of Spanish, it is insufficient for conducting the entire class in Spanish. Most of the migrant workers only speak Spanish. Nurse Betty acknowledges the importance of providing culturally competent care but is uncertain about where to begin.
Questions:
What should be Nurse Betty’s first step in preparing for her health-promotion class?
What are the language barriers, specific risk factors, and traditional healing practices that Nurse Betty should be aware of to effectively interact with the group of Hispanic workers?
How can Nurse Betty engage the community to enhance the effectiveness of her health-promotion class?
Revised Environmental Health Case Study:
Title: Investigating Environmental Concerns at Jackson Elementary School
John J. serves as the school nurse at Jackson Elementary School, which was built in 1960. Recently, Nurse John noticed an influx of students from Ms. Zee’s second-grade class visiting the clinic with complaints of coughing, sneezing, runny noses, and watery eyes. Furthermore, Steven Tea, the only asthmatic student in Ms. Zee’s class, has experienced more asthma attacks this year than the previous one. Since the rest of the school isn’t reporting similar respiratory issues, Nurse John becomes concerned that something in Ms. Zee’s classroom might be causing these health problems.
To investigate, Nurse John visits Ms. Zee’s basement classroom and is immediately struck by a pervasive musty odor. Ms. Zee informs him that the room has had this odor for years, and previous students have also complained about respiratory problems. Nurse John notices that Ms. Zee has stuffed a blanket at the base of a window because it doesn’t close properly.
After conducting some research, Nurse John discovers that moisture between a building’s exterior and interior walls can lead to mold growth, often caused by construction defects such as leaky windows. He also learns that extensive mold exposure can trigger allergic reactions resembling hay fever and worsen symptoms for individuals with chronic respiratory conditions like asthma, raising concerns for Steven.
Questions:
What steps should Nurse John take to address the environmental concerns in Ms. Zee’s classroom?
