Chronic Illness Concept

The purpose of this assignment is to critically analyze a student selected case study following an individual clients experience through an acute health crisis from admission, hospitalization recovery and discharge including adaptation to chronic illness or terminal care including death with dignity. The project is to include consideration of ethical issues, the impact of chronic illness on society, the individual, his or her family and/or significant others, and resources to assist the individual and his or her family adapt, and the implications for nursing. You will (1) select a patient, (2) review the chart (3) interview the patient, and (4) explore the current literature related to the issues facing your client identifying best practice 5) write a 5-7 page paper.

(1) Select a patient Select a client with one or more chronic illnesses, or who will become chronically ill as a result of this acute illness, whom you have cared for at some point of their hospitalization. Please do not work with a personal acquaintance, as objectivity could become a problem.
(2) Review emergency room records
a. The ER nurse assessment focuses on who what where when why how and how much?
i. Identify the chief complaint, admitting diagnosis, the data supporting that diagnosis including pertinent lab data diagnostic test, presenting s/s comparing that information to what you have learned in class regarding what is usual and customarily for the admitting dx
ii. Identify the relationship between identified underlying chronic illnesses, if any, home medication list, and previous hospitalization
b. Review the hospital course of the patient from admissions to the inpatient unit up to and including the care you personally provided
i. Utilize M.D. progress notes, nurses notes, OT, PT, lab data, diagnostic tests, clinical pathways, communication notes, I & 0 etc., integrating and correlating their progress as it relates to pathophysiology, psychosocial, developmental, and ethical issues
ii. The care map and interventions provided by you for this patient
(3) Interview the patient to get a sense of their “lived experience” will their illness, with the health care system, and its meaning for their future.
a. Follow the patients progress to discharge, the critical care unit, to LTC, or death if applicable, for as long as you can, or as far as you can, interviewing the client as you are able and their condition allows
i. identify the impact the illness/es has had on his or her life and on the family and/or significant others some of the problems and issues with which he or she has to cope
ii. how he or she has adapted to the impact on his or her life
iii. the community resources they will need
(4) Review the literature (at least four [5] references in addition to your textbook, preferably journal articles no more than 5 years old) to explore the following topics:

1. What is best possible outcome and what is the worst case scenario? What is the residual chronic illness the person will be left with after this hospitalization?
2. What is “best practice” for the treatment of this illness and its chronicity?
3. What is the impact of this chronic illness?
a. Impact on the client
b. Impact on the family and/or significant others
c. Impact on society
d. Impact on nursing
e. Financial impact
4. Problems faced by this client and issues he or she will have to deal with
a. Physical
b. Psychosocial
c. Sociocultural
d. Spiritual
e. Economic
f. Ethical
5. Interventions that could improve quality of life
6. The clients personal adaptation to chronic illness
a. Accepting help to maintain maximum functioning vs. being passive and dependent
b. Support groups
c. Community resources in or near Grays Harbor County to assist adaptation
7. The impact of the nurses in this case
a. Change agent
b. Teacher
c. Advocate
d. Ethics and the nurse
i) Ethical dilemmas in this case study
ii) How these ethical dilemmas were resolved
6. How could the nurses have intervened more effectively for this patient throughout the course of this hospitalization?

7. How the health care system has helped or hindered his or her adaptation to the chronic illness/es

(5) Write a paper. Discuss the topics outlined above and incorporate information you have gathered about your selected client.