- This topic has 26 replies, 23 voices, and was last updated 4 years, 1 month ago by
.
-
Posts
-
Collaborative Questions to Discuss for Sarah and Theo Smith
Q1: Sarah asks you if she can see her baby again. You kindly arranged a video call an hour ago as Baby Theo is still in another hospital.
What would you do?
- Make a phone call to the other hospital to see if this is possible, as you know this is a difficult situation and must be hard for Sarah.
- You decide to have a discussion with Sarah with the curtains closed around the bed. You explain to her that you have already organised a video call today and that she needs to rest and stop worrying. Her baby is being looked after and the nurses need to be allowed to do their jobs without being interrupted all the time. You will ask the nurse on shift tomorrow to organise a video call.
- Let Sarah know that you have heard her request and you will get back to her once you have
finished helping all the other patients.
Q2: Sarah is still on the ward away from her new-born baby. As you walk past you can see
that the curtains are around the bed space are closed and you can hear crying. No other staff are around.
What would you do?
- Keep walking as the curtains are obviously around for a reason and she is upset. She must want time on her own.
- Ask Sarah if you can come into the bed space and offer to support her. Listen to her concerns and put a plan of action in place for how her concerns can be better managed.
- Open the curtains and ask Sarah to explain what her concerns are.
Q3: Sarah calls you over and informs you that she is going to self discharge and go to see her baby at the local hospital.
What would you do?
- Tell Sarah that this will not be happening and that she is not ready to be discharged yet
and needs to stay where she is. - Explain to Sarah that it would not be in her best interests to leave the hospital at the moment due to her current medication, post operative condition and health. Agree to have a chat with her and the ward manager about how you can facilitate more contact with Baby Theo to ensure they are bonding as much as possible.
- Ring security and tell Sarah that they are on their way.
Q1 – I would choose option 1 because Sarah is my patient and she is distressed. To solve this, she wants to see her poorly baby – if just calling the hospital to arrange this is what it takes then I would definitely give this a go before taking any other action! It is also worth noting that as nurses we must be empathetic – in this i it must be hard for Sarah to witness other mums with their babies whereas hers is so far away from her.
Q2 – I would choose option 2 because though a patient has a right to privacy, it is in our best interest to make sure they’re physically and mentally okay, and in this case, Sarah is obviously upset. It is important to note that I would ASK if I can come in as consent is necessary when invading patients areas. Sarah can then tell me why she is upset and hopefully it is something I can fix and help her with.
Q3 – I would choose option 2 as Sarah is obviously still post-labour and has had a traumatic experience with it being a c section that effected her baby She is evidently not ready to leave so I would take the kind approach of telling her WHY this isn’t a good idea. I would explain to her what we can do to help her to see Theo more regularly over FaceTime and reassure her that she will be out as soon as we can and that she’s in the best place possible right now to recover. I would also suggest more frequent visitation of dad – or maybe her mother or any other relatives, this would make her feel less lonely and make her days in hospital go quicker! By having this conversation, we can hopefully build a therapeutic relationship in that she trusts me and will listen to me when I tell her her best interests right now.
Q1 – I would choose option 1 as it would help Sarah’s wellbeing to see her baby is ok, and calling to see if the hospital can arrange a call would not take up much time.
Q2 – I would choose option 2 as she is upset I would want to see what’s wrong and if I can help, but cannot just open the curtains as that wouldn’t be considering her privacy in her personal space and need consent
Q3 – I would choose option 2 to make sure she knows any risks of self discharging and explain how hospital is the best place for her at the minute, ask if there is anything we can do to help her feel more of a bond with Theo while shes in hospital, give her options of more video calls, pictures sent to her phone, videos of care given to him, see if any other family members are available to see him also
Q1. Option1 because I will need to call the hospital to see if it is a good time for the video call to be made, this is because Theo’s health assessment needs to be considered (noise level sensor and observation monitor) before making arrangements for Sarah to see Theo via a video call.
Q2. Option 2 because I am aware of how Sarah is feeling being away from Theo as she has previously shared that during her last video call with Theo, I will reassure her of how much progress Theo is making and how effective he is doing with receiving treatment and I will further remind her that Theo operation went well as indicated by the doctors, after reassuring Sarah, I will put a call across to the other hospital and ask if it’s possible that Sarah gets a video call with Theo to keep her mind at rest and I will also make sure to keep a record and document any response I receive from Sarah and the other hospital.
Q3. Option 3, I will be empathetic towards Sarah, explain to the ward manager of how distressed Sarah is and work on an action plan, this will make Sarah feel she’s being listened to and give her a sense of ease, it will also show that her health needs is being catered around a person centred care.
Q1 – I would choose 1, because I understand how difficult Sarah’s condition of not to see her child Theo. She needs reassurance that her child is doing good and that the only way she could see her child is through video calls. She would be able to know Theo’s present condition, and she could ask directly to the nurse looking after Theo.
Q2 – I would choose 2, because in times of difficulties being away from your child will create worries and unsettling thoughts. I will listen, give support, allow her to express her feeling and act if what are needed to ease her worries such as giving reassurance or update about her child’s condition. Addressing her concern to the Nurse-in-charge in the ward to take note of her concerns.
Q3 – I would choose 2, because it is not safe for Sarah to leave in the hospital in her present condition. I will explain that she is currently taking medication and that her post-operative condition would be risky to discharge early as she is not fully recovered. I will give support to ease her worries and recommend that there are other ways to see her child by doing video calling and I could arrange that for her.
Q1 – I would choose option 1 as we need to take a patient centered approch and if it is possible arrange another call. She is very distressed, upset and worried which might make her feel worse not only phisically but mentally. It is our responsibility to make sure she sees her child as much as possible.
Q2 – I would choose option 2 because I would consider that she might just want privacy and cry but also would want to support her in this difficult time and offer help if i can
Q3 – I would choose option 2 as it is definitely not a good idea for sarah to self discharge and this option shows the most empathy. I would explain that it is in her and theos best interest that she stays and keeps contacting the other hospital remotely as in the end she will have to be strong for theo and she won’t be if she ignores her own health.
Q1. I would choose option 1 because sometimes mothers can be transferred to the same hospital as their baby, or a later visit can be arranged/ discussion of partner and other family member visitation. Also, the neonatal nurse may be able to have a chat over the phone to better update Sarah on Theo’s progress and ask any direct questions to those caring for him.
Q2. I would choose option 2 because after hearing Sarah crying I could not just ignore her and walk past, I have a duty of care and after gaining consent to enter her private space, protecting her privacy and dignity, I would offer my support, listen to her and plan to ensure her needs are being met. I could provide advice and information on further resources she can look at independently if required.
Q3. I would choose option 2 because I would need to alert Sarah that would not be in her best interests and educate her why by calmly and professionally explaining in an approachable way, engaging with her to devise an achievable agreement, talking with the ward manager and Sarah to make an action plan. This would include facilitating more contact with Theo, increased bonding, assessment of travel arrangements for Theo dad (?funding, relative help), skin to skin contact with dad, photos and videos of Theo, which could also help when Sarah is expressing breast milk (EBM) to stimulate milk production, EBM can be expressed via portable breast pump, sent to hospital B and stored correctly in the neonatal unit, and fed to Theo via naso-gastric (NG) tube now he has had his operation which would possibly alleviate some of Sarah’s worries about later establishment of breastfeeding and what nutrition Theo is getting.
I would also direct Sarah to to the organisation ‘Tommy’s’ where she will be able to find advice and support from others in potentially similar situations and begin to explore how she can best care for Theo and herself, as a new parent.
Love your ideas for question 1! didn’t even think of the possibility of her being able to transfer to her babies hospital.
Question 1 option 1 as for me she has the right to that phone call especially if this can help her settle down. I will let Sarah know that i have to arrange the call and let her know the outcome in terms of time that this will be possible depending on the answer i will recieve.
Question 2 option 2. I definetely have to ask if i can come in this is a way of respecting patient privacy. After listening to her concern if it is something like just a moral support that i can offer her i will do so if it requires more medical attention like pain relieve for example i will let sarah know that i will discuss this with my supervisor ( the nurse i am working with on my shift) and will let her know what the plan will be.
Question 3 option 2. Although she has the right to self discharge herself i will advise the risk involve in doing so and it will be in her best interest to wait until her Discharge date as a self discharge could impact her condition and might make her come back in hospital and not able to see her child again for sometime if she has to be admitted again.
On the other hand reassured her we can try and make sure she has more video calls but this need to be arranged.Q1 – I would choose option 1, because I understand how upset Sarah feels not being able to see Theo and how she already thinks she is a bad mother. I would offer Sarah reassurance as that could cause her to be low in mood if not being reassured and call the hospital to see if it was possible to schedule another video call with Theo.
Q2 – I would choose option 2 because Sarah has a right to her privacy and gaining consent before invading her privacy is the right thing to do. Sarah is upset due to being away from Theo and I would offer her support and more reassurance and plan out a way to ensure that her concerns are dealt with.
Q3 – I would choose 2, because it is not in Sarah’s best interest to leave in the hospital as she is still in recovery. I will explain to Sarah that she is at risk of infection if she self-discharges at the moment. I will explain to her that Theo is in the best place to receive the care he needs at present and she needs to get better for her to be able to care for Theo. I would also speak to the Nurse-in-charge to devise means in which Sarah can feel closer to Theo by arranging for regular video calls, and visits from family who can in turn feedback to Sarah on how Theo was doing.
Question 1:option 1 .Because her seeing her child will help her settle and also,i will reassure her by calling the hospital and give her the outcome of the conversation with the hospital.Which will determine the next step of action.
Question 2:option 2. I would ask Sarah if i can come in because this is respecting her privacy and i will listen to the concerns she has and put a plan in place for her which will include speaking to my manager to look for the best possible outcome to support her.
Question 3:Option 3.Because she has full mental capacity,she has every right to discharge herself,however i will explain to her it would not i be in her best interest if she leaves the hospital due to her current medication ,post operative condition and health.I will speak to her on ways of making sure she has enough time to bond with TheoQ.1. Option 1: Since option one is more person-centered. In addition, Sarah’s health as a mother benefits from putting her child first. I will explain the situation to her and inform all the steps that need to be taken, such as the best time to call and the least busy times.
Q 2. Option 2: I will maintain patient privacy and obtain permission. I’d ask what’s wrong with her to make sure it’s not only that she’s worried about her baby. However, Sarah also needs assurance and encouragement that her child is in capable hands. I will pay attention to her and see how she can be supported.
Q.3 Option 2: I would tell Sarah that it wouldn’t be in her best interest to leave before she has recovered completely. I will go through the repercussions of her not completing the treatment, and will talk about her alternatives for getting in touch with her Baby and anyone else. I’ll let the nurse in charge know about the situation.
Q1. Option 1: Reason: Sarah is distressed and seeing her child will help her settle. she need reassurance and by doing that, I will contact the hospital and give her the outcome of the conversation.
Q2 Option 2: Reason: Respecting patient privacy is essential. I will first gain her consent and then listen to her, support her and I will let her express how she feels. I will give the assurance that her baby is in safe hands by reassuring her of how much her baby is progressing.
Q3 Option 2: Reason: Making sure she is aware of the risk involve if she is to discharge herself. I will reassure her that she is in the right place and that we are here to support her. I will give her options of more video calls if that will make things better.
Q.1. Option 1: Sarah needs not just reassurance that her baby will be fine but be assured of the confidence that she would be able to manage the care of the baby when she gets back home with the baby. My duty then would be to pay attention to her by listening to her attentively, make sure she can see me and make eye contact with her. Stable and not distracted and reassure her. Answer her questions truthfully. Basically what Sarah needs is confidence from the care team and confidence in her own abilities.
Q.2. Option 2: I would seek Sarah’s permission to come in. I’ll say to Sarah, “I’m sorry you’re going through this tough time…you have a great team of people behind you.” I’ll ask her if there’s anything I can do. I’ll offer her a cup of tea/food/drinks. I’ll listen to her and/hug her to reassure her and offer to be a point person if she needs anything.
Q. 3. Option 2: Although a patient has a right to discharge themselves but the goal is to encourage Sarah to stay and complete the recommended treatment. I’ll advice Sarah of the consequences of leaving before an evaluation is complete. I’ll try hard to encourage her to stay. Meanwhile I’ll document Sarah’s refusal to stay in the patient’s chart what extent I went to making her stay. If she insists on leaving, I’ll make sure I document and if possible get witnesses and make sure I document that the risks of leaving is documented in her chart. discuss follow up with the doctor.
Q1. I would choose option 1 because it must be so difficult for Sarah to not be able to see and hold her new born baby. I would reassure her that her baby is in safe hands and let her know I will make a phone to the other hospital if it’s possible for her to have another phone call today and inform her the outcome.
Q2. I would pick option 2 asking for consent first if I can come into her bed space, I will also listen to her concerns and tell her she is not alone she can always reach out if she needs to talk and if there is anything I can do to make the situation better. I will also inform my manager about sarah’s concerns and see if we can draw up an action plan.
Q3. Option 2 I will explain to her the risk of her discharging early and try to encourage to stay and I will also speak to my manager if there is a way for Sarah to get regular phone calls and inform the manager what Sarah told me.
Q1 – I would choose option 1, it would seem appropriate to reassure Sarah and try to get her to communicate with her baby as soon as possible. For Sarah’s mental health and wellbeing it would also be important to reduce her stress levels, letting her see her son via video call would improve her state of mind. Time to bond with her baby is so crucial after giving birth and hope as her nurse I would have the empathy to assist her maintain contact with her son.
Q2 – I would choose option 2, hearing Sarah crying would prompt me to want to find out why she was crying and how the issue could be resolved. Having a clear plan of action and documentation of how to implement the plan would promote consistent and continuous care within the multidisciplinary team in my absence.
Q3 – I would choose option 2 – calling security or restricting Sarah to the ward environment poses restraint issues that may not be appropriate at the time if Sarah has full capacity to make informed decisions. Sarah has every right to self discharge, however, she needs to be informed of the consequences and impact on her health if she were to self discharge. I would prefer to try and persuade Sarah to continue treatment and emphasise how she would be better able to look after Baby Theo post-treatment.
Q1- I will choose the option1 because it hard for Sarah to be far away from her new born and that can cause her to be mentally unstable if she is not supported effectively
Q2- my option will be the 2-because she needs to be given some comforts and be reassured
Q3- Will be option 2 to avoid any desperate and unfortunate decision from SarahQ1 – I would choose option one because it embraces the patient centred approach. Considering that taking baby Theo to another hospital might have made Sarah to be distressed, I would make the phone call using good communication skills as this might improve the outcome for Sarah.
Q2 – I would choose option 2 because it is the option that treats Sarah as an individual and it upholds her dignity which supports the NMC code of Prioritising people. It also recognises that consent is a continuous process because despite speaking with Sarah when we made the call, I still had to ask again if I can come to her bed space.
Option 2 also recognises that there’s a need to always act in the patient best interest because it made clear how Sarah should be listened to (clear communication) and the need for a plan of action that will manage her concerns.Q3 – I would choose 2 because the 6Cs are embedded in the response. The other options might be too extreme considering that the Mental Capacity Act allows an individual to make unwise decisions except they don’t have the capacity.
Q1. Option 1:The option i would go for would be option one. It is vital that Sarah is supported during this difficult time. i will tell Sara that i would do my best to make the phone call but warn her it might be busy again. I would also offer lots of reassurance and encourage Sarah to ask questions so that she can get all the information that will help her understand Theo’s status better.
Q2. Option 2: I would choose option two as i have a duty of care. The first step would be to have her consent. I would then try to assess how Sarah is copping with Theo being away from her. I would do this through listening and asking questions. I will offer lots of reassurance and encouragement. I will pass the relevant information to my mentor.
Q3. Option 2: I would immediately inform Sarah that it would not be in her best interest to leave the hospital. I would remind her of her ongoing treatment plan and inform Sarah of all the risks that are involve in not going through with the treatment. I would also get her consent to discuss her concerns further in order to come up with plans that will meet her needs. I will offer reassurance and tell Sarah that she is safe here.
Q1- I would choose option 1 because arranging a video call for Sarah to see her baby, who is in a different hospital, will enhance Sarah’s parental experience, provide her with reassurance, and reduce anxiety, depression, and Post-Traumatic Stress Disorder (PTSD).
Q2- I would choose option 2 because family-centered care is important in providing care in paediatrics. Collaborating and including Sarah in all aspects of her baby’s care reduces stress and the effect of her seeing Baby Theo’s appearance.
Q3- I would choose option 2 because explaining to Sarah the potential consequences of her discharging herself from the hospital will empower her in making the right decision. And also, having a chat with her and the ward manager to ease contact with Baby Theo will reassure her and reduce stress and anxiety.
Q1: I would do option one as this is in line with patient centered care and Sarah should be allowed to see her son whenever she wants to. In the future, I might try to pre arrange frequent video calls with the hospital at set times throughout the say so Sarah is able to see her baby frequently and she knows when she will be able to see him again which may ease her anxiety surrounding not seeing him. This would also mean the ward staff are more likely to be able to facilitate this contact as they can plan ahead of time, making sure there is staff around to help with the contact.
Q2: I would do option two. When having personal conversations it is important to keep the curtains closed as although not a lot, they do provide some privacy and dignity to the patients. Sarah has just been through a traumatic experience and needs lots of support so it is best to go behind the curtain with her permission and try and ease some of her worries.
Q3: i would do option two as education is paramount in providing holistic patient centered care. Giving Sarah all of the information as to why it is in her and Theos best interest to stay at the hospital will allow for her to feel more empowered and comfortable with the situation she is in. This means she is more likely to follow the medical advice.Q1 – I would choose option 1 is a patient-centered approach, and it is critical for Sarah to feel as though she is being listened to and heard during this difficult time. Allowing Sarah to see her child as often as she wants will also help to reassure her and put her mind at ease.
Q2 – I would choose option 2 because it is critical that Sarah maintains her privacy, so we must obtain consent before entering. I would then take the time to listen to all of Sarah’s concerns and offer her support and reassurance to alleviate her anxieties.
Q3 – I would choose option 2 and explain to her that staying in the hospital is in her best interests so she can heal and care for Theo. I would go over all of the risks of Sarah not finishing all of her treatments and discharging herself prematurely. Assure Sarah that Theo is in capable hands and is being well cared for, and that she can speak with Theo via videocall whenever she wants. I would relay the conversation to the ward manager and discuss the possibility of Sarah being transferred to the same hospital as Theo.
Q1- I would choose option 2 because first giving Sarah assurance that Theo is being provided good care in the other hospital would reduce the stress that she is having and secondly suggesting the arrangement of a video call would also uplift her since she will be able to see Theo as well as speak to the nurses taking care of her baby.
Q2- I would choose option 2 because as Sarah is patient it is my responsibility to make sure that she gets the best care she needs, so I would get consent first from her to let me open the curtain so I could talk to her and find out how I can best help her.
Q3- I would choose option 2 because with all the complications she and Theo have gone through Sarah would be making confusing decisions that would compromise her healthy so I would let her know the consequences of self-discharge and let her speak to the nurse in charge.
Question 1: Option 1: It is recommended to make the call. That will help in reassuring Sarah on his baby’s Theo situation and adequate care plan in place in recovery. The noise at the background can be kept low by noise level sensor and observation monitor before making the video call.
Question 2: Option 2: Sarah will need reassurance because of her last video call. Her complain and worries. Also to seek further professional consultation in Theo’s health assessment.
Question 3: Option 3: I will support Sarah and explain to the ward manager how Sarah is distressed to put an action plan in place. Her mental health should be supported.
- You must be logged in to reply to this topic.
