Scenarios about Patients and Nurses

Julie:
You were discharged home from hospital 4 days ago and are recovering at home.  You have been experiencing some pain and stiffness in your right arm following your surgery, this has been affecting the quality of your sleep and you are tired.  The physiotherapist has provided you with some exercises to increase the range of movement in your arm. You have been doing these exercises, however you are feeling rather frustrated and worried about the slow recovery.  You have to ask your husband to help you get washed and dressed.  Julie has been doing these exercises daily, but is frustrated that her arm is still very stiff, it is affecting her ability to wash and dress by herself.

You have a post-operative appointment with your consultant next week, when you hope to find out what stage your cancer is at and whether more treatment is needed. You are scared about finding out, as the student nurse begins to take out your sutures, you find that you are crying and say that you are frightened.  

Scenario 1 Nurse:

Julie was discharged from hospital 4 days ago following a radical mastectomy for breast cancer.  She has attended the practice nurse for removal of her sutures, which you have been asked to do.  You have read Julie’s notes before her appointment and are aware that she has an outpatient appointment next week. You also know that she has been having physiotherapy for stiffness in her right arm.  As you begin to remove Julie’s sutures you see that she is crying and she tells you she is frightened about the future and what it holds for her.  

Ali:
It is Ramadan and you have been attending an outpatient appointment for your renal failure.  The clinic has been delayed and your appointment was late, you are now waiting for hospital transport to come and take you home.  Unfortunately this has not arrived. Whilst you are not fasting you are keen to get home before iftar, as you want to celebrate this with your family. You have already asked staff about your transport but no-one has got back to you with any information.  You are frustrated and approach the nurse’s desk to ask what is happening, the nurse you speak to says she doesn’t know.  You are angry and begin to shout saying that no-one listens that that you have to get home soon.  

Scenario 2

Scenario 2 Nurse:

You are sitting at the nurse’s desk when Ali approaches.  Ail has been attending an outpatient appointment and is waiting for transport home.  The clinic was delayed and transport had to be rearranged.  When Ali approaches he asks the nurse sitting next to you if she knows anything about his transport.  The nurse says she doesn’t, at that Ali becomes angry and starts to shout saying that no one understands how important it is for him to get home soon.  

Helen:
You are feeling confused and upset, though you don’t know why.  Usually you feel happy and can sometimes remember where you are and your husband and family when they visit. Recently though you have had a cough and get very breathless, you find this upsetting and when one of your favourite nurses is with you, you ask her about this.  

 

Scenario 3 Nurse:

You have been closely involved in Helen’s care and you have developed a trusting relationship with her.  The nursing staff and Helen’s family are aware of her diagnosis of metastatic lung cancer, however Helen has not yet been told.  The decision not to tell her was based on her dementia and her family’s wishes for her not to know.  Helen does still have times where she is quite lucid and aware of her surroundings.  It is during one of these that she asks you why it is that she is so out of breath all the time and why is it not getting any better.

Fred:
You have been in the intermediate care unit for 5 days now after being admitted to hospital following a fall at home.  While you have been here you have been receiving physiotherapy and your mobility, and confidence, have increased.  The occupational therapist has visited your home, with Mavis, and has arranged for some equipment to help you.  You are feeling more confident about going home, and Mavis is looking forward to it.  You are still concerned about your medication, you are not sure why you are taking some of your tablets and what they are for.  You have asked for some information about these to help you when you are at home.

Scenario 4 Nurse:
Fred has been in the intermediate care unit for 5 days following a fall at home.  His mobility, and confidence, have gradually improved with regular physiotherapy.  The occupational therapist has visited Fred’s home with Mavis and has provided some aids, a commode, perching stool and bath seat.  Both Fred and Mavis are feeling more confident about his discharge home.  However, Fred is still anxious about his medication, he is not sure what he is taking and why.  Your mentor has asked you, as part of Fred’s discharge planning, provide Fred with some education about his medication.  Fred is currently taking:  GTN nitrolingual spray PRN, isosorbide mononitrate – 40mgs mane, lisinopril – 10mgs mane, furosemide 40mgs nocte and paracetamol 1gm QID.

Charlotte
You have been admitted to A&E following a fall at home. You are still very unsteady on your feet and have become quite anxious and agitated as you are finding it difficult to find the right words to explain yourself. The nurses have said that you will be transferred to a ward for assessment and then probably onto a rehabilitation facility. You know your boyfriend James’s mother is currently in hospital and he may not be at home. You have been told you have had a stroke and you want to talk to James about it. No one seems to understand what you want and you are frightened. You are worried about James and how he might be able to support you. You want to speak to him above all else.  A student nurse approaches you to complete your blood pressure and you refuse to allow this to happen until you have spoken to James.

Scenario 5 Nurse

You have been asked to assess Charlotte with a view to transfer to the Medical Assessment Unit. Charlotte has been diagnosed with a CVA and at present her speech is affected.  She has new mobility issues and is very anxious and is getting quite agitated.  As a student nurse you have been asked to complete her observations prior to transfer and report back to your mentor having documented these.

Rosie
You are to play Ms. Elizabeth Cook; mum to Rosie, a 25-month-old girl. Rosie’s Health Visitor visits you because there is concern that Rosie is not meeting her developmental milestones and has not been gaining any weight. Rosie still likes to have bottles of milk and sugary drinks throughout the day and you have a chaotic and disorganized life style as you adhere to no routines. You tend to eat takeaways, as these are more convenient. As a new mum, you are not overly concerned about what is wrong with your child as you were a fussy eater as a child.? 

Scenario 6 Nurse
As a student nurse, your supervisor has asked you to discuss with mum and Rosie about what meals and foods Rosie normally eats and when she eats them. At her 24 month developmental review her weight gain was poor and she was not meeting all of her developmental milestones. You are to sign post mum to the NHS Change4Life eating healthy guidance.