Case Study Scenario:Bridget Farmer is 37 years old and identifies as an Aboriginal woman. She has four children aged 14, 12, 8 and 1 year old. Her partner, Thomas, 37 years old, works as a fly in/fly out miner in WA. He is away for six weeks at a time, and then has two weeks at home each block.

The family lives in a small country town, one hour away from the closest regional town. Bridget does not have any immediate family nearby. They initially moved there for Thomas’ work and bought a home with a mortgage, however the mine nearby closed and so Thomas had to take the interstate job. Bridget can only work on a casual basis because she has to care for the children when Thomas is away. It has been a quiet time at her work, so she has only been getting one day a week. Money is tight, so Bridget and Thomas budget carefully.

Recently while Thomas was away at work in WA, their 1 year old child was hospitalised with croup. He had to be transferred to the regional hospital an hour away, which meant Bridget had to take all the children with her. Unfortunately, there was no hospital accommodation for families, so during the day, the children spent the time on the ward with her. At night time, Bridget had to stay on the ward with the baby, as he would scream whenever she left his bedside. The children slept in the car, as Bridget couldn’t find affordable accommodation and didn’t know what else to do. Staff notified the Department of Community Services (DOCS) and now Bridget feels like she’s a criminal. She feels that they have discriminated against her because she is Aboriginal, and no one came to talk to her about what was happening. She feels helpless and frightened that they may take her children away from her.

Bridget has returned home and has come to see you at the medical centre. She is feeling stressed and anxious, the baby is still recovering and not quite back to normal, very clingy and requiring her constant attention. The other children are back at school, but she feels bad that they had to miss almost a week of school and thinks that might give DOCS more reason to take them away. She tells you she has always been a good mother and would never have done anything like this but she did not know what else to do. Staff at the hospital were too busy to take time with her and she is angry they did not come to her to ask what was happening. Since returning home she has not been able to work because the baby has been so unwell, and she is worried about paying the bills.

 

Part 2: Short answer questions

Using the Social Determinants of Health of assessment tool (see Figure 1 below) and the Wellness Model of care from the online module and Tabbner’s Nursing Care, answer the following questions.

Q.1- List three social determinants of health that affect Bridget and her family and explain how you would plan her care based on these:

q.2- What services could Bridget have been referred to while her baby was hospitalised in the regional hospital?

q.3 Discuss three external factors that affect Bridget and her family?

q.4- As the Enrolled Practice nurse at the local medical centre, discuss the community resources you can recommend to help Bridget, now they are back at home?

q.5 Discuss three internal factors that may affect Bridget and her family.?

q.6- You are forming a nursing care plan for Bridget, list three actual or potential problems that you have identified from the scenario?

q.7- From the list of problems you have made, identify three different multidisciplinary team members you could refer Bridget to?

q.8- Bridget has asked you about private health insurance, as the older child has been told she will need corrective treatment for her teeth and will need braces. Explain to Bridget what you know about private health insurance and where she can find further information?

q.9 Refer to the models of health and wellness discussed in Koutoukidis, G., Stainton, K., & Hughson, J. (2017).Tabbner’s Nursing Care: theory and practice (7th ed.). Elsevier Health Sciences, pp79-80:

a.Define one of the models in your words

b.How could you apply this model to Bridget’s better understand care requirements, including social and emotional wellbeing, and her health beliefs and practices?

q.10 Research and name a rural town in NSW australia and identify what community resources are available for Aboriginal and Torres Strait Islanders in this town?