Nursing Assignment: Raelene Ward Case Study and Care Theories

This nursing assignment examines the case of Raelene Ward, a 40-year-old Aboriginal woman who experienced healthcare during her pregnancy and gestational diabetes. The assignment explores the application of person-centered and family-centered care, ethical considerations, and Erikson...Read More

Running head: NURSING ASSIGNMENT
THE PATIENT EXPERIENCE AND PARTNERING IN CARE
Name of the Student
Name of the University
Author note

1NURSING ASSIGNMENT
Introduction
It is the fundamental right of aboriginal individuals to receive equal and quality treatment
without any discrimination like other communities do. With this thesis statement, this assignment
will discuss the case study of Raelene Ward, who is a 40 year old aboriginal woman who
experienced being a patient in a healthcare facility due to her pregnancy and gestational diabetes
(Kerr & Hayward, 2013). While receiving care in the healthcare facility she faced several
effective and ineffective nursing interventions that affected her health care experience. In this
assignment, several theories will be applied in case of Raelene Ward’s care such as family
centered and person centered care as well as for the health care professionals, the code of ethics
and its importance will be discussed. Besides this, application of Erikson’s 8 stage framework
will also be used for the care process of Raelene ward (Holmes et al., 2013). Moreover, with the
discussion of theories and framework, the communication process, effective and ineffective care
process and partnering in care strategy with strategies to maintainof patient experience will be
discussed in this assignment.
Identification of relevant theories and frameworks applicable in case scenario
It has been witnessed with the support of several researches that application of family
centered or patient centered care is the process using which patient experience about care process
is easily enhanced. In this case of Raelene Ward the person centered care and family centered
care will be applied and the nursing professionals will be asked to comply with the ethical code
of conduct (Inzucchi et al., 2015). While communicating with Raelene, it was observed that after
the diagnosis of gestational diabetes, the health care professionals did not provided a detailed
information about her health condition and directly applied insulin instead of diet or nutritional

2NURSING ASSIGNMENT
modification or oral medication to control the diabetes (Barry & Edgman-Levitan, 2012). This
indicated towards the ethical violation of code of conduct as the health professionals should
always take care of patient’s autonomy. Therefore, the care process should involve person
centered care as a detailed information about the ailment and effective intervention will help the
patient to support the health care professionals in the application of health interventions (Kerr&
Hayward, 2013). On the other hand, Erikson’s 8 stage frame work will also be applied in the case
scenario which helps the care professionals to identified 8 different negative and positive and
negative aspect of care scenario that could affect the patient experience (Holmes et al., 2013).
This will be applied in the case scenario, so that the loopholes present in the care process of
Raelene ward could be removed and the care process could comply with the chosen theories and
framework.
Analysis of communication scenario:
On closely evaluating the case scenario it can be revealed that two evident care providing
frameworks can be detected which includes effective and ineffective care. According to Kitson et
al. (2013) effective care and ineffective care have been classified under the subtypes of
providence of positive and negative care. Providence of effective care broadly relies upon the
providence of a patient centred holistic care (Douglas et al., 2014). In order to dispense effective
care, it is mandatory to incorporate effective training so that care providers are able to stringently
evaluate patient needs and accordingly provide care. Further, it can be said that ineffective care
broadly relies upon the inefficiency of the healthcare professionals to meet the needs of the
patient and apply appropriate interventions (Gulanick & Myers,2016). According to the
information dispensed by the case study, it can be stated that the subject Raelene Ward was
affected with gestational diabetes. The case study further states that Raelene Ward was an

3NURSING ASSIGNMENT
aboriginal woman who had been admitted to the hospital to seek medical guidance. However, her
experience mentions clearly that she faced both effective and ineffective care during her
treatment.
Evidence of ineffective care is detected from the manner in which the client was treated.
The case study states that Raelene was a nursing professional herself and the manner in which
she was treated was extremely biased. There was no proper intimidation dispensed to her about
her treatment procedure and she claims to not have been informed in any way about her illness
condition. The care procedure did not involve a holistic approach. No efforts were undertaken to
introduce dietary changes or include a fitness routine in order to monitor the blood pressure and
glucose level. Instead, the client states that she had been administered insulin injections directly.
Hence, it can be concluded, that an ineffective treatment care was provided to the patient.
However, an instance of effective care can also be witnessed on closely evaluating the
case study. The care providers engaged in the treatment of the client maintained a track of the
blood sugar level of the patient and administered insulin in order to control and regulate the
glucose level. Scientific evidences reveal that administration of glucose can effectively control
elevated level of glucose in the blood and has been found to be extremely effective in controlling
gestational diabetes. The case study further mentions that the client was visited by a nutrition
expert on a regular basis every week. Hence, it can be deduced that the dietary expert kept a
track on the diet intake of the patient and effectively planned a diet chart. These elements reflect
the providence of a holistic medical care. However, it is important to make the client understand
the procedure of the treatment in an effective manner and educate the client about the disease
condition which was not done at any step. The professional background of the client might have

4NURSING ASSIGNMENT
played a major role behind the disparity of the treatment. Hence, it can be said that the care
provided was not effective (Papastavrou et al.,2014).
Application of chosen theories and framework
The application of chosen theories and framework are important, as it will help to
enhance the patient experience about the care and make the care process compliance to the
social, ethical and culturally compliance (Kuo et al., 2012). Further, it will also help to reinforce
the effective care process for Raelene and being an important stakeholder of the care process her
importance and participation will be improved. As per the patient centered care process, she will
be informed with all the important information and then informed consent will be obtained so
that ethical compliance could be achieved (Carman et al., 2013). This will make the care process
effective and improve the patient experience. On the other hand, as per the family centered care,
members of her aboriginal community that helped her in her crisis situation will be included in
the care process so that they could be informed about any critical care related decision (Tinetti,
Fried& Boyd, 2012). Moreover, after all these theories, application of Erikson’s 8-step model
will be applied in the care process and due to this, the patient will be able to understand the
importance of self-management as well as the implication of physical and mental changes
(Deci& Ryan, 2012). Further, with the application of this, help the health care professionals to
make the care process as per the preference of patient. They will be able to apply their creative
problem solving skills to reinforce the ethical code of conduct and the ethical aspect of the care
process sin the care process to maintain the autonomy of the patient (Vahdat et al., 2014). This
will help o make the care process creative, effective and sharp, as the health care professionals
will be able to use their critical thinking to improve the patient condition (Burke, Evans& Jarvik,

5NURSING ASSIGNMENT
2014). Hence, this is the way the care process should include the applied theories and framework
in the care process of Raelene Ward.
Conclusion
Health has been categorized as a basic element to support life. It must be noted that
individuals get adequate access to health care facilities. A major discrepancy in terms of
providing health care facility to individuals have been observed in Australia where a gap has
been noticed in terms of providence of care to aboriginal and non-aboriginal people. It can be
said in this context, that there is a need to revise the health care facilities. The case study reveals
the providence of ineffective care to the client based on professional and cultural disparity.
Hence, it can be suggested that adhering to the Erikson’s eight stage model can effectively help
in improvising the manner in which treatment is dispensed to enhance the health status of
individuals across the world.

6NURSING ASSIGNMENT
References
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-
centered care. New England Journal of Medicine, 366(9), 780-781.DOI:
10.1056/NEJMp1109283
Burke, W., Evans, B. J., & Jarvik, G. P. (2014, March). Return of results: ethical and legal
distinctions between research and clinical care. In American Journal of Medical Genetics
Part C: Seminars in Medical Genetics (Vol. 166, No. 1, pp. 105-111). DOI:
https://doi.org/10.1002/ajmg.c.31393
Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J.
(2013). Patient and family engagement: a framework for understanding the elements and
developing interventions and policies. Health Affairs, 32(2), 223-231. DOI:
https://doi.org/10.1377/hlthaff.2012.1133
Deci, E. L., & Ryan, R. M. (2012). Self-determination theory in health care and its relations to
motivational interviewing: a few comments. International Journal of Behavioral
Nutrition and Physical Activity, 9(1), 24. DOI: https://doi.org/10.1186/1479-5868-9-24
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M.,
Lauderdale, J., ... & Purnell, L. (2014). Guidelines for implementing culturally competent
nursing care. Journal of Transcultural Nursing, 25(2), 109-121.
Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans-E-Book: Nursing Diagnosis and
Intervention. Elsevier Health Sciences,pp 32-40

7NURSING ASSIGNMENT
Holmes, G. M., Morrison, M., Pathman, D. E., & Fraher, E. (2013). The contribution of
“plasticity” to modeling how a community’s need for health care services can be met by
different configurations of physicians. Academic Medicine, 88(12), 1877-1882.doi:
10.1097/ACM.0000000000000026
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... &
Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a
patient-centered approach: update to a position statement of the American Diabetes
Association and the European Association for the Study of Diabetes. Diabetes
care, 38(1), 140-149. DOI: https://doi.org/10.2337/dc14-2441
Kerr, E. A., & Hayward, R. A. (2013). Patient-centered performance management: enhancing
value for patients and health care systems. Jama, 310(2), 137-138. DOI:
doi:10.1001/jama.2013.6828
Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of
patientcentred care? A narrative review and synthesis of the literature from health policy,
medicine and nursing. Journal of advanced nursing, 69(1), 4-15.
Kuo, D. Z., Houtrow, A. J., Arango, P., Kuhlthau, K. A., Simmons, J. M., & Neff, J. M. (2012).
Family-centered care: current applications and future directions in pediatric health
care. Maternal and child health journal, 16(2), 297-305.
DOI:https://doi.org/10.1007/s10995-011-0751-7

8NURSING ASSIGNMENT
Papastavrou, E., Andreou, P., & Efstathiou, G. (2014). Rationing of nursing care and nurse–
patient outcomes: a systematic review of quantitative studies. The International journal
of health planning and management, 29(1), 3-25.
Tinetti, M. E., Fried, T. R., & Boyd, C. M. (2012). Designing health care for the most common
chronic condition—multimorbidity. Jama, 307(23), 2493-
2494. doi:10.1001/jama.2012.5265
Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient involvement
in health care decision making: a review. Iranian Red Crescent Medical
Journal, 16(1).doi: 10.5812/ircmj.12454