This Competency Assessment assesses the following outcome(s):
NU416-M6: Assemble evidence-based nursing interventions that maximize wellness for complex patients with chronic co-morbid conditions and is consistent with chronic care delivery model.
GEL-7.02: Apply ethical reasoning to ethical issues within the field of nursing.
Mr. Bale is an 85-year-old who is oxygen dependent following a recent diagnosis of Chronic Obstructive Pulmonary Disorder (COPD). (He has a history of smoking 2 packs per day for 50 years.) He also has two other chronic co-morbid conditions: Congestive Heart Failure (CHF) and hearing loss. Mr. Bale and his wife live independently at the home of their eldest son, daughter-in-law, and two grandchildren. Two other children also live close. Mr. Bale immigrated to the U.S. from Mexico to the U.S. many years ago and became an American citizen 15 years ago. Mr. Bale’s primary language is Spanish; however, he does speak and understand limited English. His family generally translates for him.
Mr. Bale is receiving Western healthcare through the local healthcare system, but also continues to use cultural remedies he learned in Mexico many years ago. Recently there has been a concern that he continues to smoke in the house despite the agreement he signed when oxygen therapy was initiated.
For this case study, you will write a 3-4-page descriptive essay that addresses each of the elements listed below.
1. Introduce the reader to Mr. Bale, his family, and his situation.
2. Think about the impact that Mr. Bale’s three co-morbid conditions would have on him and his family.
- What health/safety problems and risk factors can you identify?
- Explain why the identified problems and risk factors are threats to Mr. Bale’s health and safety.
- How would the Chronic Care Model assist in Mr. Bale’s care?
3. If you were the home health nurse, how would you approach this situation?
- What evidence-based interventions would you employ to address at least three of Mr. Bale’s health issues?
- What communication strategies would you employ?
- Provide rationale for your choices.
4. There are several ethical situations in this case study regarding Mr. Bale and his family.
- Identify one ethical dilemma.
- What is the underlying ethical principle behind the identified dilemma?
- Propose two possible solutions to this ethical dilemma.
- Which solution do you support as the appropriate course of action and why?