Case Study Discussions – Responding as the Newest Registered Nurse (RN) (staff member) In the Emergency Room

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CASE STUDY:
Mr Vincent Brody is a 71-year-old man who lives with his 66-year-old-wife Thora in their family home in a quiet suburb in Hobart, Tasmania. They have one daughter who is in her mid-forties and lives in NSW. Mr Brody has continued to smoke one to two packets of cigarettes a day for 50 years. He was diagnosed with Chronic Obstructive Pulmonary Disease (COPD) two years ago and has just been admitted to hospital with his first acute exacerbation of the illness. Mrs Brody has suffered from rheumatoid arthritis since her early thirties and to date has been well managed by her GP and Specialist although caring for her husband is increasing her frailty. Mr and Mrs Brody’s daughter flies in from NSW to provide support to her parents.
Mr Brody is now six days post admission and has been transferred from the medical ward to rehabilitation. The acute exacerbation of COPD is under control with oxygen therapy and medications and he is almost ready for discharge. The Discharge Nurse organises a multidisciplinary team meeting with Mr Brody’s wife and daughter and the discharge plan is forwarded to the couple’s GP. An appointment with the GP is made to discuss Mr Brody’s condition and how his oxygen therapy and his ongoing care might be managed in the home environment. Mr Brody is then discharged home.

Mrs Brody recently visited her General Practitioner (GP), for a review of her rheumatoid arthritis. The GP is concerned that because of her increasing physical and cognitive frailty she will no longer be able to care for Mr Brody at home. The GP refers Mrs Brody to a geriatrician for a comprehensive geriatric assessment (CGA).
Before the assessment is undertaken, Mrs Brody falls heavily in the shower and fractures her hip. Mr Brody calls their daughter Stella in great distress. It is Stella, who from inter-state, calls an ambulance and after assessing Mrs Brody the paramedics transfer her to the Emergency Department (ED). As you are getting Mrs Brody settled into ED Cubicle 3, you overhear another staff member saying “try and get the old lady in cube3 home ASAP. She’s just a geri-syndrome”. Mrs Brody hears this too and asks you “what’s a geri-syndrome? I can’t go home like this. Who will look after my husband?” Mrs Brody then starts to cry.
Case-Study Question:
AS THE NEWEST REGISTERED NURSE (RN) (staff member) IN THE EMERGENCY ROOM (ED), HOW WILL YOU RESPOND TO THIS SITUATION?
Critically discuss how you, as a health professional, can
overcome barriers to effective inter-disciplinary
communication to ensure safe, quality, timely and appropriate
care, or services, are provided to the older adult.

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