Case Study Of A Woman With Bilateral Gangrene Discussion

Amy, a junior nursing student, was assigned to care for Flora, an eighty-fiveyear-old woman with bilateral gangrene of the lower extremities secondary to diabetes mellitus. Flora’s treatment regimen included maggot therapy. She was on strict contact isolation due to methicillin resistant staph aureus (MRSA). Amy came to clinical well prepared but with some obvious apprehension as she began her day. She donned a gown, gloves and mask before entering Flora’s room for an initial nursing assessment. The usual morning care followed: breakfast, medication administration, bathing and tedious dressing changes. Flora was hearing impaired, so Amy leaned close to her and spoke clearly in her ear. Flora chewed her food slowly, but Amy very deliberately helped her take each bite of breakfast, a process that took over thirty minutes. Flora was afraid and in pain, so Amy touched her gently and combed her hair carefully, gave good skin care and held her hand. Flora said she couldn’t remember when her family last visited, so Amy read each of her greeting cards to her and listened as Flora reminisced about family. Amy opened the curtains to let Flora feel the warmth of the sun and see the activities outside her window. Case Study Of A Woman With Bilateral Gangrene Discussion

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Flora was confused, due to sleep deprivation, so Amy developed a plan for a soothing bedtime routine. When Flora refused to take her medications, Amy 26 helped her with each pill, calling pharmacy to get liquid meds where possible. Flora dreaded the painful dressing changes to her lower extremities, but Amy carefully explained each step in the process and used strategies to minimize the pain Flora experienced. When a wandering maggot escaped from under the edge of the dressing, Amy unobtrusively removed it. Amy was weary as she came out of the room after morning care, sweat matting the hair around her face as she sat down for the first time in two hours to do her charting. When her instructor returned later, she found Amy back in isolation gear, sitting in Flora’s room, holding her hand. When her instructor asked Amy why she returned to Flora’s bedside, she replied, “I saw Jesus going back into that isolation room to bring comfort to a lonely woman, but I knew Flora would not be able to see him, so I went instead.” (Adapted from Carol Bence, “I Went Instead,”Journal of Christian Nursing, spring 2003, pp. 4-5.) Discussion Questions 1. In what ways does Amy’s care for Flora illustrate the principles given in the Bible passages above? 2. How did Amy’s personal faith affect her nursing care? 3. What did Amy’s care for Flora imply about the way she viewed her patient? 4. How did Amy alter Flora’s environment to enhance her care? What seemed to enable Amy to endure the discomfort in her environment? 5. What seemed to be the goal of Amy’s care for Flora? How do you think she viewed health? 6. Describe one of your most difficult patients. How could you apply similar approaches in your nursing care for this person? Case Study Of A Woman With Bilateral Gangrene Discussion