Case study 3: Joey

Question Case study 3: Joey  You are a community health nurse who visits and case manages Joey, a 31-year-old man who lives with his parents in the community. Joey has a paranoid illness that became acute and caused him to act violently towards a local shopkeeper. Joey was arrested and then taken to a local acute mental health unit and made an inpatient under mental health legislation. His condition was stabilised and with the help of regular injections of anti-psychotic medication he was discharged. These medications are administered by you in his home. In hospital the care team recommended Joey for discharge to a supported accommodation unit run by a local charity. However, Joey’s choice was to return home and continue living with his parents, who have taken on the role of his legal guardians. This was a significant sacrifice for his parents. They now rarely have breaks from caring for Joey, and their friends feel awkward in Joey’s presence when visiting the home. When you visit Joey, you often find him a bit non-communicative although his parents – with whom you have a good rapport – say he is usually affable when he is alone with them. As part of his aftercare plan, Joey agreed to continue to receive his scheduled injections. Recently though, he has refused an injection you came over to administer. You know from his medical records that this is an indication that Joey is rapidly becoming acutely paranoid again. You ask Joey if you can advise his parents that he has not had his injection. You feel that in their role as Joey’s carers, his parents need to know of his decision. Joey says he does not want his parents to know. QuestionResponseIdentify the legal/ ethical issues in this situation. Explain your duty of care and likely course of action as a nurse in this situation. In your response, explain your reasoning and decision making process. Explain whether this situation could require mandatory reporting and why. Who would you need to disclose this situation to? Explain how you would approach obtaining consent from the relevant parties to provide Joey with his injection.   Case study 4: Tom  You are a nurse working in an oncology adolescent unit. You have been providing nursing care for Tom, a 15-year-old boy, for the last six months. Tom is an only child, and his mother and father have really struggled to come to terms with his cancer diagnosis. Tom’s mother has given up her job as a teacher to care for Tom and support him through his treatment. Tome went into hospital recently for a routine tonsillectomy and was found to have an oesophageal tumour. Further scans revealed Tom had a secondary tumour in his stomach. Tom has undergone radical surgery resulting in short-term tracheostomy, radiotherapy and chemotherapy. Tom underwent further scans at the end of his last chemotherapy cycle. Yesterday, you sat in on a consultation with Tom and his family while his oncologist discussed his progress. It was revealed that Tom has developed another tumour, in his small intestine. The oncologist proposed prompt radical treatment of further surgery and chemotherapy. Tom’s parents were keen to start the treatment program as soon as possible. You noticed that Tom looked uncomfortable during the discussion and did not add much to the conversation or decision-making process. Later in your shift, you take the opportunity to talk to Tom by himself after his parents have left the ward. Tom informs you that he doesn’t want any more surgery or chemotherapy. He tells you he just wants to get out of hospital and be a teenager as long as he has time left to enjoy it. Tom states that he feels his mother was very pushy about getting the treatment, but he has made up his mind. He wants you to help convince his parents and the doctor to honour his wishes. QuestionResponseIdentify the legal/ ethical issues in this situation. Explain your duty of care and likely course of action as a nurse in this situation. In your response, explain your reasoning and decision making process. Describe what you would say to Tom’s parents to advocate on Tom’s behalf.  Not sure if my answers are correct or following the question. Need some assistance please Health Science Science Nursing NURSING HLTENN010 Share QuestionEmailCopy link Comments (0)

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