To Any Advanced Practice Nurse

[LoveAlwaysV]

I have to get input from an advanced practice nurse on a family case study for the RN-BSN bridge program I am in. My original interview never came through; your help would be greatly appreciated! Here is the case study:

During my preceptorship on a pediatric unit, I cared for a six year old patient who had recently lost the ability to enjoy most of the simple pleasures in life. I will refer to this patient as Jonathon. Just a couple months earlier, Jonathon was like most other six year olds enjoying life to the fullest; yet now Jonathon had no signs of voluntary movement besides tracking with his eyes. His feet were hyper-extended and had to be forced into therapeutic boots for several hours during the day to prevent this from becoming permanent. He received all of his feedings via g-tube. He could not speak, and the only indications of him being unhappy or in pain were fast respirations, a painful whine, a groan, or constant sobbing. These indications of pain and discomfort were common, occurring every time he was moved, turned, or woken up from a sound sleep.

Jonathon had contracted a case of bacterial meningitis. Unfortunately this was not caught early on. Jonathon was put through 3 separate courses of oral antibiotics when his doctor mistakenly diagnosed him with an upper respiratory infection. Jonathon's early symptoms included neck pain, fever, and fatigue, and occasional complaints that his head hurt. It was not until Jonathon experienced a severe headache that caused him to scream in pain all the way to a hospital that he was given additional tests and finally diagnosed. During his hospital stay it was found that Jonathon had experienced multiple mini strokes which left him in his current state of paralysis.

On the particular morning I was caring for him, Jonathon's dad was at his bedside and that afternoon he opened up to me and told me the tragic story of how their family's life was turned upside down within a matter of months. Jonathon's father and mother were living a normal life with their three kids in a small town both working steady full time jobs. This unsuspected turn in their lives changed everything. Jonathon had now been in the hospital for about two months. His father and mother would rotate nights in the hospital while the other would sleep in an RV parked outside. Jonathon's mother would have to return back to work in a week; she worked in the healthcare field. Their two other children were being watched over by their grandmother. They were both constantly haunted with thoughts that they should have sought a second opinion; that they should have known this was something more serious. Jonathon's mother was understandably under a huge amount of stress did not seem to handle it as smoothly as his father. She was untrusting of the hospital staff and did not enjoy the nurses coming in and out of the room throughout the night. Jonathon's hospital regimen was adjusted to fit the family's needs. An assessment was done before bedtime and night meds were changed to before bedtime or held until morning. Staff was told not to enter the room throughout the night unless requested. She liked to take Jonathon's vital signs herself. She had been known to get into arguments with the nurses and occasionally requested a different nurse for her son. All of the nurses eventually knew that when his mother was at bedside they had to be extra careful with their words and actions. Some would say that Jonathon's mother was inappropriate, but the amount of stress that the family was being put through was unbelievable.

1. Your name & advanced practice role

2. Education and experience required for your role

3. What concerns you the most and what steps would you take

Thanks in advance :redpinkhe