Strength Based Nursing Care Plan for Emma Gee: A Case Study

Running head: CNA343
Emma Gee case study
Name of the Student
Name of the University
Author Note

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Introduction- Strength based nursing (SBN) refers to an approach that focuses on care
of people, which encompasses eight core principles that guide the nursing profession, thus
promoting self-efficacy, hope, and empowerment of the patients (Gottlieb 2014). Across
different levels of care that range from primary care services for healthy patients, to critical and
acute care services for patients who are unconscious, the domain of SBN primarily focuses on
reaffirming the goals of a nurse for promoting the health and wellbeing of the patients,
facilitating easy recovery and healing process, and alleviating all kinds of suffering.
This is principally achieved by development of an environment that strengthens the
capacities of the patient for health and the associated mechanism self healing and recovery.
According to DeNisco and Barker (2013) SBN is found to compliment medical care and also
assists or supports by providing a language that facilitates easy communication, regarding the
contribution of nurses to the health and healing of the patient, thereby empowering them to gain
increased control over their quality of life (Moyle, Parker and Bramble 2014). The essay will
focus on the case study of Emma Gee, an occupational therapist who had been admitted to the
hospital following an episode of stroke. This will be followed by formulation of a strength based
care plan during her transition journey.
Strength based nursing care plan- Despite increasing attention that that is being paid to
wellness prevention and patient centred care, the medical model that places an emphasis on the
deficits of the patients, rather than their strengths, often remains the most commonly used
practice model in clinical services (Tourangeau et al. 2016). Most nursing professionals have
been trained to place a due focus on the problems that are faced by the patients, which in turn is
facilitated by conducting an analysis of the concerns and thoughts of the patient. In the words of
Ibrahim, Michail and Callaghan (2014) formulation of strength based nursing care plan will

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help in bringing a balance to the deficit based care plans and it will focus on gaining a deeper
understanding of the problems within the holistic and broader context that will uncover the outer
and inner strengths of the client Emma Gee.
Following Emma’s admission to the hospital where she is being delivered adequate care
services in the Intensive Care Unit (ICU) and is gradually regaining consciousness, it is utmost
necessary for the nursing professionals to provide her assistance in feeding activities. Stroke
most often affects the way by which food moves around in the mouth and the swallowing
capabilities of a person, thereby leading to a condition called dysphagia. This condition most
often creates problems with drinking and eating and the food or drink might get inserted in a
wrong way or inside the lungs (Rofes, Vilardell and Clavé 2013). Conduction of a swallowing
assessment is essential to evaluate the oesophagus and its associated functions. The Fiberoptic
Endoscopic Evaluation of Swallowing (FEES) might also be used to determine the functionality
and anatomy of the swallowing apparatus and its associated reflexes. Dysphagia results in
aspiration and some of the most common signs and symptoms include shortness of breath and
wet sounding voice. Hence, assistance is also required from a speech pathologist for managing
dysphagia (Wan et al. 2014). A dietician will help in ensuring that Emma is being provided
adequate nutrition and is taking proper nutritional supplements (Crary et al. 2013). Collaboration
with a speech pathologist will also help in checking the muscles that are used for swallowing
food. Videofluroscopy or modified barium swallow can also be used for the same purpose. This
should be followed by supervision and/or assistance from speech pathologist such as, drinking
thickened drinks, or eating smooth foods that are considered safe, besides suggesting movements
that would make swallowing easier and safer (Edmiaston et al. 2014). Therefore, effective
collaboration is required from the nurse in charge, the speech pathologist and dietician who will

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take all possible efforts to make Emma show compliance to a well formulated diet chart that will
enhance her health status and help her tolerate certain drinks and food. Conduction of frequent
pain assessments, making a regular note of her vital signs, managing integrity of the skin, and
assessing the psychological functioning of the patient are also imperative in this case study. The
patient should also be frequently repositioned, with the aim of promoting her optimal recovery,
which will be achieved by modulating the muscle tone and preventing complications such as,
respiratory problem, pain, contracture, and pressure sores.
The case study also hints at communication deficits in Emma that resulted in a failure of
her family members and the nursing staff in interpreting what she intended to say. Although a
white board has been brought by her sister, effective collaboration between the therapists and her
family members will help in gaining a deeper understanding of the different strategies and
communication techniques that should be employed in this scenario. Flynn et al. (2013) stated
that several stroke patients report difficulties in their communication that commonly includes a
history of dysarthria, apraxia, cognitive difficulties, and dysphonia. The speech pathologist will
assess Emma’s reading, talking, listening, understanding, and writing and will work together
with the family members for developing a rehabilitation program. Some of the commonly used
resources that might prove beneficial in this context are presence of white boards,
communication signals and pictures. Talking in a quiet place where there is no distraction,
speaking in simple short sentences, obtaining feedbacks to make sure that the instructions have
been correctly interpreted or understood, and using different gestures might prove helpful
(O'Halloran, Worrall and Hickson 2015).
Emma’s family that comprises of her father, mother, and sister has been found to be
extremely supportive in her recuperation journey. Hence, a family centred partnership