Case Study:
Jen is a Rural Area Nurse (RAN) working at a rurally based health service in the Kimberley area. She is called on Saturday evening to go and visit a farmer out of town. James Bird is 60 years old and lives on a large 5000 ha property with his wife Sue, who is a teacher. Jen first visited James two days ago after he was referred to the community nursing team from the acute medical ward in the hospital for treatment of cellulitis in his lower left leg following a superficial laceration which he sustained after falling from his quad bike while checking cattle.
This was James's first experience of being in hospital. He was anxious being away from his farm and preoccupied with the risk of fire to his property due to the 'dry spell'. James had insisted on returning home and the doctors agreed to transfer him to the community nurses as he was well supported at home by his family. With this in place, he returned home on oral antibiotics and required a daily wound dressing to his leg. Sue calls Jen, worried that James in unwell and worried that he has developed a fever again and states there is a smell coming from the wound. The visit to James and Sue's property involves a 45km drive on an unsealed road taking an hour due to poor road conditions.
Jen arrives at the house at 9.30p.m. to find James in bed. He has not eaten since breakfast and appears dehydrated. He is shivering and has a temperature of 39.5C. James also appears to be in a low mood stating: "I'm useless. I can't even get to the toilet let alone take care of the farm". He is also experiencing significant leg pain. On discussing James's return home, Jen learns that Sue is working full-time as a teacher which is taking her away from the farm for long periods of time. This leaves James alone during the day. James and Sue have three sons who live and work on neighbouring properties with the closest being 30 km away. The farmhouse, built on stilts, is very old and has six steps up to the entrance. The toilet is also external to the house about 50 m away.
Please use literature to support ALL of your answers (in and end-text APA referencing is required).
Question One (10 marks)
As a Rural Area Nurse visiting James, discuss four priority concerns regarding James's health and well being. Support your discussion with evidence from the literature.
Question Two (10 marks)
Considering the role of RAN, discuss two possible safety concerns for the nurse visiting James and detail two strategies for risk assessment and management. Refer to the literature to support your answers.
Question Three (10 marks)
You are working with Jen and she asks you to complete a Psychosocial assessment for James. Discuss the data this assessment gathers and give four example questions that you would ask James. Support your discussion with evidence from the literature.
Question Four (10 marks)
Discuss four cultural and language considerations when providing care to any client in their own home and how these could affect your ability to provide effective ongoing care as a RAN. Support your discussion with evidence from the literature and provide a link to any cultural considerations for James.
References
Please list in APA format all references used.
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