Nursing assignment on the challenges faced by Erin and her mother during hospital care

Question

Task: Discuss the challenges that Erin and her mother experienced whilst seeking hospital care. Describe strategies for health professionals to promote shared decision making and improve the experience and outcomes for either Erin. Discuss the key elements of person-centred care and provide evidenced based rationales in your nursing assignment.

Answer

1. Challenges Faced By Erin and Her Mother During Hospital Care as mentioned in the nursing assignment
Erin considered in this nursing assignmenthas been diagnosed with Intellectual Disability and she sought health care as any other patient encountered with a major stroke.During her encounter with her stroke, she visited a doctor and was told to go back home and rest as the doctor has already given up on her because she had Intellectual Disability (Tuffrey-Wijne et al., 2013).During her hospital visit and seeking professional help from the doctor, it is found in this nursing assignmentthat she has stringently faced several challenges as a cause of her Intellectual Disability diagnosis. Some of the challenges faced by Erin during her hospital care are disclosed in this nursing assignment.

Firstly, she has faced the challenge of social decisions instead of medical decisions- Every professional doctor has the sole responsibility of treating their patient with the best medical remedies (Scholl et al., 2018). However, in the present nursing assignmentstudy of Erin, it was evident thatthe doctor irrationally took a social decision instead of a medical decision. This is so because the Doctor immediately after hearing about the stroke, prescribed no remedies and took her back home asshe was a patient withan Intellectual Disability. She was not provided with medical remedies for any other patient who shall be diagnosed witha stroke. Thus, it was clear from the nursing assignmentthat the doctor diagnosed Erin on the basis of a social decision that Intellectual Disability is a matter of serious attention and has no remedies.Thus, he prescribed the patient be taken backand not be treated as per other patients diagnosed with Intellectual Disability (Boland et al., 2019). This is strongly wrong on the part of the doctor as the doctor is bound by medical remedies. Secondly, another challenge that Erin has faced mentionedin the nursing assignmentis of inequality. Erin was diagnosed with Intellectual Disability and that is why she was not treated at par with other patients who faced a stroke. Thus, she evidently witnessed inequality because of her Intellectual Disability.The Doctor and other medical staff did not treat her right and vehemently violated her right to equality. In accordance, in terms of routine medical treatment, she has witnessed engravinginequality during her medical care (Wilson et al., 2020).

Thirdly, it is found in this nursing assignmentshe has also faced the challenge of lack of knowledge and awareness of her issue. It is further evident from the case study thatthe doctor, as well as the medical staff, did not possess the required knowledge and skill to treat Erin and make her feel comfortable with her Intellectual Disability (Bomhof-Roordink et al., 2019). However, the medical professionals lacked proper knowledge and this turned out to be a serious challenge for Erin.

2. Challenges faced by Erin’s mother as primary caregiver
The challenges that were faced by Erin’s mother mentioned in the nursing assignmentare somewhat similar in nature. However, one additional challenge that her mother faced as a primary caregiver was the lack of availability of knowledge and infrastructure to treat Intellectual Disability. It is evident from the present nursing assignmentstudy that Erin was rejected upfront without even considering her present health status upon hearing about her Intellectual Disability (Andersonet al., 2019). This is evidently wrong and challenging for a primary caregiver to seek the right opportunities for her daughter to help her overcome her health condition.

Challenges faced by the hospital staff
Moreover, there are certain challenges mentioned in thenursing assignmentthat were faced by the hospital staff as well. The hospital staffbrainstormed about the limitations of medical science as regards Intellectual Disability. This is why, it was clearly evident for them to state that Intellectual Disability has too many limitations and cannot be treated hence, upon hearing about the stroke, the patient was advised to be taken back (Byrne et al., 2020). The hospital staff lacked the basic infrastructure required to treat such patients with Intellectual Disability at par with other patients diagnosed with a major stroke.

Strategies for health professionals to promote shared decision-making and improve the experience and outcomes
Strategies for shared decision-making
There are some strategies for shared decision-making mentioned in thenursing assignmentare:
a. Taking the participation of the patient
b. Exploring and comparing the treatment remedies that are available for the patient to help the patient to improve their condition
c. Examining the values and preferences of the patient in accordance with the present health condition
d. Coming to a final decision for treatment of the patient

However, it was evident in the present nursing assignmentstudy that these strategies for health professions to promote shared decision-making issues were not complied with. This is so because the decision making power was not shared with the patient and her mother. The medical professionals in the present case study of Erin have already taken the decision of not treating her in accordance with her Intellectual Disability issue (Moloney et al., 2021). This is why, it is clear from the nursing assignmentthatthe patient’s values were not considered and examined and that is why the principles of shared decision-making were not complied with.

Some of the strategies to improve such experiences and outcomes for people like Erin are to provide the power of shared decision-making and reach a final decision making with the help of understanding the values and experiences of the patient.

3. Key elements of person-centred care and evidence-based rationales in the nursing assignment
There are a few key essential elements of person-centered care in nursing and healthcare studies.Some of the key elements of person-centered care in nursing and healthcare theories are the following in the nursing assignment:

Figure 1: Principles of Person-centred Care
Source: (Bonell etal., 2020)

a. Respecting the individual –One of the foremost key essentials of person-centered care is of respecting the patient irrespective of her present health condition. However, in the present nursing assignmentstudy, Erin and her mother were not treated with respect irrespective of her health condition.Treating an individual with dignity is essential and has to be relied upon with evidence-based rationales (Bonell etal., 2020).It is essential in delivering person-centered care thatpatients are recognized for their unique qualities and skills and are identified other than their present health condition.In the very beginning, Erin was recognized by her health conditions.

b. Coordinated Care - Another important key element of person-centered care is that of delivery of coordinated care (Delaney, 2018).In the present nursing assignmentstudy, coordinated care was not provided to Erin because of her health condition and she was asked to be taken back home as there is no hope for improvement of her health condition. This means that coordinated care has to be delivered in accordance with an organized plan and care.

c. Understanding the experience and goals of the patients –Another important key essential of person-centered care is that of understanding the experience and goals of the patients.It is important for the medical staff to relate with the patient’s state of mind and their experience and then treat them in accordance.In the present nursing assignmentstudy, the medical professionals failed to understand the experience and goals of Erin and her mother. Her mother wanted to treat Erin like any other patient that had witnessed stroke.

However, in the present nursing assignmentstudy, it was witnessed that these key essentials of person-centered care were not complied with. It is clearly evident from the present case study that the patient was experiencing mental health conditions as she was not treated in accordance with alike patients who has experienced a major stroke. It is further evident from the present nursing assignmentstudy that the patient was not respected and dignified because of her experience and goals (J. I., et.al., 2019). This is why her experiences of dealing with Intellectual Disability was not understood by the medical professionals and irrationally it was suggested that she shouldn’t be diagnosed because of her experience with Intellectual Disability.Further, it is also evident from the nursing assignmentthat coordinated care has to be delivered to the patient as such care with provide treatment with a organized care plan and help the patient to be treated more efficiently. But in the present nursing assignment, it is evident that the medical practitioner’s lacked the required knowledge and infrastructure to treat the patient andmake an organized plan for the patient.

References
Anderson, R. J., Bloch, S., Armstrong, M., Stone, P. C., & Low, J. T. (2019). Communication between healthcare professionals and relatives of patients approaching the end-of-life: a systematic review of qualitative evidence. Palliative medicine, 33(8), 926-941.

Boland, L., Graham, I. D., Légaré, F., Lewis, K., Jull, J., Shephard, A., ... & Stacey, D. (2019). Barriers and facilitators of pediatric shared decision-making: a systematic review. Implementation Science, 14(1), 1-25. Bomhof-Roordink, H., Gärtner, F. R., Stiggelbout, A. M., & Pieterse, A. H. (2019). Key components of shared decision making models: a systematic review. BMJ open, 9(12), e031763.

Bonell, C., Michie, S., Reicher, S., West, R., Bear, L., Yardley, L., ... & Rubin, G. J. (2020). Harnessing behavioural science in public health campaigns to maintain ‘social distancing’in response to the COVID-19 pandemic: key principles. J Epidemiol Community Health, 74(8), 617-619.
Byrne, A. L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One, 15(3), e0229923. https://doi.org/ 10.1371/journal.pone.0229923
Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia. Collegian, 25(1), 119-123. Moloney, M., Hennessy, T., & Doody, O. (2021). Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence. BMJ open, 11(2), e039647. doi:10.1136/ bmjopen-2020-039647
Scholl, I., LaRussa, A., Hahlweg, P., Kobrin, S., & Elwyn, G. (2018). Organizational-and system-level characteristics that influence implementation of shared decision-making and strategies to address them—a scoping review. Implementation Science, 13(1), 1-22.
Tuffrey-Wijne, I., Goulding, L., Giatras, N., Abraham, E., Gillard, S., White, S., ... & Hollins, S. (2014). The barriers to and enablers of providing reasonably adjusted health services to people with intellectual disabilities in acute hospitals: evidence from a mixed-methods study. BMJ open, 4(4), e004606. doi:10.1136/bmjopen-2013- 004606
Wilson, N. J., Howie, V., &Tomsic, G. (2020). Nursing and people with intellectual disability. In Nursing in Australia (pp. 139-150). Routledge.