Students are required to review and critique the care given in a case study. You are not critiquing evidence, the CPG, or the standards. The critique of care is to be based on:
A critique is not a description of care or the case study. A critique involves analysing the care, interpreting the care, assessing the care, identifying positives and negatives (what was done well and not so well and why) and offering suggestions for improvement.
Students are to critique four (4) episodes of care. These can be positive or negative elements.
An “episode of care” is any time that care was provided. This could be an assessment, a nursing intervention, a referral to another service, or even an omission of care. Episodes of care can reflect themes, such as communication, assessment, symptom management, cultural/spiritual needs, family needs etc
Case Study
Background:
Maureen is a 76-year-old female, a native of Vanuatu, was brought up with two parents and her three siblings. Maureen’s upbringing was family orientated and she was fortunate to be well educated. Maureen is multi-lingual and is proficient in English, French, Bislama and Oceanic. Maureen completed her primary and secondary schooling in Luganville, Vanuatu. After secondary school, she was awarded a scholarship to study in Fiji and graduated as a Community Nurse. Maureen worked as a school nurse in the local Presbyterian school when she returned to Luganville.
Social History:
Maureen met her husband, Peter Jones, an Australian National whilst working at the school in Luganville. The couple relocated to Australia after the birth of their first child Mark. Maureen and Peter had two further children, Karen, and Lisa. The family lived in the suburbs of Melbourne and made yearly trips back to Vanuatu to visit Maureen’s family. These family trips continued until the children were young adults.
Spirituality:
Maureen is a daughter of a Presbyterian missionary and consequently was brought up with a strong Christian faith. Maureen and Peter brought their children up in the Christian faith and made sure their children practiced not only Christianity, but also Vanuatu culture and beliefs.
Cultural:
Like Australian Aboriginal narrative customs, the culture of Vanuatu embraces myths and legends. Storytelling, songs, and dances are important forms of communications and form these traditional tales. The story of Vanuatu’s history and landscapes are at the forefront. Art is a fundamental part of the social life and ritual celebrations. The Vanuatu culture respect the land and pay homage to the past and present custodians. Maureen, through inheritance remains a custodian of the land that her family once owned. This remains very important to Maureen.
Life in Australia:
Whilst the children were young, Maureen upgraded her qualification from Fiji that enabled her to hold Nursing registration in Australia. Maureen gained employment at the local Community Health Centre as a Community Nurse. Maureen initially found it difficult settling into life in Australia, being away from her family and her local Presbyterian community. Peter encouraged Maureen to engage in the church community in Australia. Maureen formed many friendships though the church in the Melbourne suburbs. Maureen was often volunteering her time at the local congregation by sharing her love of cooking especially sharing the traditional dishes of Vanuatu. Maureen’s love of cooking has been passed on to both her daughters. When Maureen and Peter retired, they engaged in more voluntary activities in the Pacific region through charity organisations and would sometimes spend six months or more in Vanuatu. The couple funded and helped build a classroom block at the local Luganville primary school where they had both previously worked. Throughout Maureen’s life, she has developed a large circle of friends, most of whom share her love of volunteering. In recent years, due to their age and increasing health issues, the couple reduced their holidays and travelling and only visited Vanuatu for special occasions such as family reunions and funerals.
Past Medical History:
Although Maureen maintained a healthy lifestyle, she was diagnosed with a peptic ulcer just after Karen was born (1973) for which she was prescribed a combination NRSG374: Principles of Nursing Palliative Approach Page 3 of 8 of antibiotics, H2 blockers and proton pump inhibitors (PPI’s) for a 2-month period. This treatment appeared to work in subsiding Maureen’s symptoms. In 1990, Maureen was hospitalised with a recurrence of the peptic ulcer and is now taking a PPI indefinitely to assist with this condition. In 2012, Maureen had a hospital admission following a stroke. The stroke resulted in moderate left arm and leg weakness. With Peter’s support, Maureen maintained a reasonable level of functional ability when discharged from having the stroke. Six years ago, Maureen was diagnosed with Alzheimer’s disease and was still in the care of Peter. Maureen also experiences recurrent UTIs, osteoarthritis and hypertension.
Current Social:
Peter died 2 years ago, following a cardiac arrest. Mark, now fifty (50) years old, trained and worked as a policeman, however a motor accident three years ago has left him physically impaired, and wheelchair bound. Mark lives with his wife Beth and their two sons, in the same suburb as the family home. Karen, the older daughter and second child is forty-seven (47) years old and lives in Perth with her husband Ross and their three children. Karen also has two young grandchildren who reside in Perth. Lisa, the youngest daughter of Maureen and Peter is fortythree (43) years old, un-married and has no children. Lisa now lives with Maureen and is her Financial Enduring Power of Attorney (EPOA) and primary carer.
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