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NRS326 International and National Perspectives on Primary Health Care

Question

Answered

Question:

Case Scenario (Domestic): Donna 1

Donna is 42 year old woman who lives in Walgett in northern NSW. She has just been diagnosed with type 2 diabetes mellitus by her GP, and has been given a referral to a specialist three hours’ drive away in Dubbo. Donna has a history of asthma and has a BMI of 28.  

Donna grew up in Walgett and has lots of family members living nearby including her mother, several brothers, and many members of her extended family. Donna is single and has three adult children aged 20, 22 and 23.

Donna left school at the end of Year 10 and has worked casually as a cleaner throughout her life. In the last two years, however, most of her regular clients have cancelled her services due to financial insecurity resulting from drought. Donna says that her work always used to keep her active, but now that she is not working as much she has put on weight and feels fatigued all the time. She says she has never been able to exercise because of her asthma.

Donna’s two youngest children live at home with her. Her son, Paul, has worked as a farm labourer but is currently unemployed. Her daughter, Casey, works ten hours per week in a local bottle shop and is looking for more work. Casey’s two year-old daughter Violet also lives with them. Donna looks after Violet while Casey is working or staying at her boyfriend’s on the weekend. 

Prior to the drought, Donna’s income was enough to comfortably cover her major expenses such as rent, groceries and petrol. There was usually some money left which she liked to use to get her hair or nails done, or save for Christmas.  Since the drought took hold and Donna’s income has dropped, she is only able to pay her rent and buy basic groceries. Donna buys pasta, milk and bread in bulk and makes large family meals such as macaroni cheese, spaghetti bolognaise and lasagne. She used to occasionally buy fresh fruit and vegetables but became frustrated that it was often wasted because it went off, or her family did not like it. Donna now prefers to prioritise food that will be eaten by her family without fuss. She also likes to buy chocolate, soft drinks and cakes for her family, as she says that “they need something to cheer them up - times are tough at the moment”. 

Donna used to drink tap water throughout the day, however since Walgett switched to bore water in 2018, Donna has stopped drinking tap water because she does not like the taste. She now has a few cups of tea with two teaspoons of sugar each day.

In 2018 Donna was diagnosed with influenza and spent a week in Walgett Multipurpose Service on IV antibiotics. Donna did not know that influenza could be so serious, and she had never heard of “Fluvax” before. During her hospitalisation, Donna’s extended family and friends were very supportive. They visited her regularly, took turns caring for Violet and ensured that Donna’s pets were fed. Since that time, Donna has ensured that she gets “Fluvax” from her GP every year, and she encourages her family and friends to do the same. 

Task

Using the ‘4Rs Model of Reflective Thinking’, write a reflective piece in relation to the case scenario “Donna”, which is provided on the I2 site.

  • Reporting:Report the patient’s situation. Make observations about the case scenario and evaluate the key issues. Observe and reflect on your own attitude and thoughts towards the patient in this case scenario.
  • Relating: Make connections between the patient’s situation and your own personal and professional experience, skills or knowledge. Have you encountered patients in similar situations before? What was similar/different? Do you have appropriate skills and experience to manage this scenario? 
  • Reasoning: What factors have contributed to this patient’s situation? Critically analyse the impact of culture and social determinants of health on the well-being of the patient with reference to relevant literature. 
  • Reconstructing:How would you manage a similar situation in the future? Discuss evidence-based practice which could support the patient to make sustainable changes to improve their well-being. Identify strategies which can enable communities and healthcare teams to support people in similar situations.

 

NRS326 International and National Perspectives on Primary Health Care

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