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Case Study, Chapter 8: Grand Nursing Theories Based on Interactive Process 

After reviewing the theories, models, and frameworks from this chapter, consider the following Case Study and discuss the questions. 

Case Study:

Susan Frank is a nurse in a home care agency and she is making her initial visit to a new patient. The patient’s name, Jay Gold, looks familiar, and when she enters his home, she finds she knew him in her former job. Susan had first met Mr. Gold more than a decade ago when she was working on a medical unit at the local community hospital. At that time, Mr. Gold had been admitted to the hospital for diabetes with ketoacidosis. It was at this time that he discovered he had insulin-dependent diabetes. During his initial hospitalization, he was started on insulin and had to learn to care for his diabetes. In the weeks that followed his hospitalization, Mr. Gold returned to the medical unit to see the nurses who cared for him each time he had a visit with his dietician and diabetes educator. As his diabetes came under control, Mr. Gold returned to his outgoing, energetic baseline. He talked to the nurses about his sales job, his wife, and his two daughters and told them how much he had learned in caring for his disorder.

Susan was shocked to see Mr. Gold’s appearance now. He was lying in his bed with his back to her and did not look up when she entered the room. As she spoke to him, she noted that his color was ashen. His voice was soft as he spoke, and he appeared depressed and lethargic. He had had a right above the knee amputation (AKA), and Susan noted a large scar on his chest. She reviewed his record and found that Mr. Gold’s diabetes had progressed rapidly and that he had multiple complications. He had had a coronary artery bypass graft (CABG) 2 years ago and was also being monitored for decreased renal function. He had vascular problems and neuropathy, which led to the AKA. The reason for the home visit was that Mr. Gold was found to have osteomyelitis, requiring 6 weeks of intravenous antibiotics.

Mr. Gold is married. He and his wife live in a pleasant, 2-story condo in an upscale community in a quiet retirement area. His two grown daughters are married but visit often. Susan learns that Mr. Gold has not been able to work for a number of years and is relying on Social Security disability and his wife’s part-time job.

1. Select one of the nursing models/theories from this chapter that will help Ms. Frank in assessing Mr. Gold and planning for his care. Why did your group select that model?
2. Based on the model selected, what additional information would Susan want to collect/assess?
3. Based on the model selected, how would Ms. Frank initiate a plan of care for Mr. Gold?
4. Do you think that Susan would assess and plan differently for Mr. Gold’s care if she used a different model for Mr. Gold? Why or why not?

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In this case study, I would select the theory of self-care deficit nursing theory that was proponent by Dorothea E.Orem. The method is vital as it mentions the Parson’s structure theory and Von Bertalanffy’s system theory. This is because the two theories were capable of explaining the issues that Mr. Gold was undergoing in his system, for example, the amputation of one leg (AKA) and the effects that he was going through with the provision of self-care considering she was privy to his past. The theory focuses on the modern realism, and it views the patient as an agent. It portrays a high developed formalized theoretical system, and presently it is being referred to as the theory of self-care science and in coming up with the new self –care plan.  She will utilize Orem’s magnum opus, and she will derive many quotes examples from the past encounters.

2.

According to the appearance of Mr. Gold, it seems that he was lethargic and ashy indicating that he is not being taken care of well at home. Ms. Frank should ask him his state of affairs of interaction with his wife. It also seems that though he is staying in a well up the condo, the finances are down; thus the nurse should ask about his life savings and other retirement insurance policies that were held by him. Finally, though the two daughters were regularly visiting hi, plus his wife was working, Ms. Frank should be asked about their financial relationship with his family and his ailing so that she can formulate an appropriate care plan.

In initiating the care, Ms. Frank should utilize all the additional information that she has received from Mr. Gold plus the physical, physiological and psychological information that is present in formulating it.  The other thing is that she should take care of the other advantageous conditions that can  affect Mr. Gold as he is recuperating considering…………………………………………………………………………………………………………………………………………………………………………………………………………………………………. Grand Nursing Theories Based on Interactive Process ………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

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