Assignment: Cardiomyopathy And Congestive Heart Failure

Case Study 2

Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

Describe your approach to care.

Recommend a treatment plan.

Describe a method for providing both the patient and family with education and explain your rationale.

Provide a teaching plan (avoid using terminology that the patient and family may not understand).

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■ Professional jurisdictions: the boundaries of work ‘owned’ by a profession.

■ Authority: the type of authority that a profession has to undertake its work.

And from Witz (1992): ■ Exclusion: attempts to ensure that members of a profession are prevented from undertaking specific aspects of work.

■ Usurpation: attempts to include specific aspects of work normally carried out by another profession.

These concepts were used to frame the research questions and were also used to develop a model to try to explain the past and present situation in relation to doctors, nurses and prescribing.

The research data were then collected through observation, semi-structured interviews and document analysis at two case study sites. Categories and sub-categories were identified from the data and described as part of the study.

The discussion could have centred on the categories identified. However, it was at this point the data were brought back to what the categories had to say about the above concepts and how the research questions centred on these concepts were

answered. There were new conceptual models developed from the data that represented variation between the two sites in terms of the concepts identified at the beginning of the research.

An example of a conceptual model can be seen in Figure 1. As this shows, the weight of intervention by the management of the organisation to support nurse prescribing seemed to have an effect on its introduction to the organisation but the main concepts are visible in the model.

A conceptual framework was present throughout the research project and report. It helped frame the research’s questions, design and outcomes. The same data may have been collected if a different theoretical or conceptual framework had been used or if no framework had been there, but it is likely that it would have been represented differently. The use of a framework helped the researcher to order her thoughts and organise the way the data would be represented.

The use of a conceptual framework had started as an academic exercise to fulfil the demands of an academic supervisor and the expectations of a PhD project. It is probably only now, looking back at the project, that the extent to which the conceptual framework pervaded it is apparent. The existence of the conceptual framework was helpful in ensuring the research was given order and achieved completion in a way that could clearly be communicated to its readers.

Figure 1 Workplace authority for the supply and prescription of medications by nurses

Supportive doctors

The state Supply and prescription: intellectual jurisdiction

Exclusion

Usurpation

Organisation

Non-supportive doctors

Nurses Supportive

doctors

The state Supply and prescription: intellectual jur

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