Question

I Slaying at an acute care facility for over 3 months now. She has uveral years from chronic obstructive pulmonary disease and was placed on mechanical ventilation last fall. She was initially admitted to your facility for a weaning trial from the mechanical ventilator. For the past 3 months, she has failed several trials of weaning. Last night, the physician informed her that she was to leave the acute facility, connected to the mechanical ventilation, and that no further trials will be initiated. This morning, you asked Mrs. Schmidt about her preparations for leaving the facility. In response, Mrs. Schmidt starts crying dramatically and asks to see the attending physician. She is extremely upset, stating that "no one had told her anything about this." She is adamantly asking for an extension of her stay and for another weaning trial. Two weeks later, Mrs. Schmidt is completely weaned from the mechanical ventilation. However, she still has a Foley catheter (a thin, sterile tube inserted into the bladder to drain urine) in place, which she refuses to let go, saying that, she cannot be without it." 1: What are some of the potential challenges for communicating with Mrs. Schmidt? 2. : How would you assess for these challenges? 3. : What are some of the potential explanations for the communication difficulties described in this vignette? 4. : Is there anything that should have been done differently? 5. : How would you explain Mrs. Schmidt's refusal to let go of the Foley catheter? Tell us about Something fundamental you will take with you about the chapter as related to the case study. How can this knowledge enhance your career as a nurse and you, as a person? (I need a response from each person from the group). Dieudonne donne Berlinda Que 11/04/ Matilda

Answer 1

1. Mrs Schmidt is of a stern mindset and is hesitant to let go even after clinical evidence has been brought up in front of her. This poses as a difficult problem.
2. To assess for these challenges, through communication with Mrs Schmidt which might explain the reasoning behind her behavior is needed. This might provide some insight as to why and how she's having these problems.
3. There can be a number of explanations, some of which are Mrs Schmidt's age, her prolonged mechanical ventilation, her dependence on hospitals, her denial, etc
4. The attending physician could've explained things in a more detailed manner, laying down every little detail and giving her time to think about it.
5. Mrs Schmidt has become used to the catheter/become dependent on it and this refuses to let go of it