Reference no: EM133311486

Case Study: Mrs. Monique Bolanger is a 61-year-old widow who lives alone. She has struggled with obesity most of her adult life, gaining significant additional weight since her husband died 3 years ago. Currently, she would be classified as morbidly obese, with a BMI of 58.3 (155 cm tall and 140 kg). She now cannot go upstairs in her home and is only able to wash up in the powder room on the main floor. She has begun sleeping in her recliner in the living room as that is the only place she is comfortable. She has begun to experience partial blindness in her right eye over the past year as a result of age-related macular degeneration. She struggles with pain in her knees and hips and has started using a walker for support. 24 hours before admission she tripped over one of the dog toys on the floor and fell. She was unable to get up and lay on the floor until the next day, when her dog walker arrived and found her. She has no fractures, but upon assessment in the ER she was found to be slightly dehydrated and unable to weight bear due to pain. She has been admitted for rehydration and to be seen by physiotherapy to help her to begin walking again. She has also been diagnosed with type 2 Diabetes. She has been referred to the Registered Dietitian for a consult.

After several days on the unit, a patient care conference is held because the team members have begun to feel as though they are all not working toward the same goals for Mrs. Bolanger.

Vera Wong is her physician. Dr. Wong is an advocate for an evidence-based approach and believes that the best possible outcomes for Mrs. Bolanger would likely occur if she was referred to one of the 11 Bariatric Centres of Excellent in Ontario.

Isabella Bosca is a Registered Dietitian working in this hospital. She has met with Mrs. Bolanger and begun the process of learning about her history of issues with eating and weight, exploring more about the progressive weight gain after her husband's death. She believes that an approach that focuses on baby steps. She believes that the only approach is one that considers the social, financial, emotional, physical, and psychological contexts and conditions is essential. Isabella objective is to develop a plan of care that is shared with the patient and is reflective of Mrs. Bolanger input

You arrive at the meeting to find Dr. Wong and Isabella contentiously discussing their views. As you sit down, each of them looks toward you and demands that you declare "which side" you are on. You consistently practice in a theory-guided, evidence-based nursing practice approach.

Your task:

Question 1: Describe to your two interprofessional colleagues how a Theory Guided Evidence Based Nursing Practice (TGEBNP) approach can represent both of their perspectives and include a focus on the client's desires. Be sure to integrate a specific grand or mid-range theory and how that would intersect with Evidence-Based Practice (EBP).

Question 2: Why might it be more valuable to have COMPLIMENTARY perspectives than