Reference no: EM133562153

Case Study: Isabella is a 4-year-old girl who showed signs of a viral illness that did not seem to get better for 2 days. Her mother, Sonia Ramirez, took her to a local walk-in clinic, where she was reassured that Isabella had a bad cold but would recover within a few days. She was given a teaching sheet about viral illnesses that, after getting home, she realized she could not understand. The next day, however, Isabella was barely responsive and had numerous dark purple spots. Her mother rushed her to a local emergency room. Isabella was intubated and airlifted via helicopter to a major medical center, where she was diagnosed with meningococcemia, a life-threatening infection.

Isabella subsequently had bilateral amputations of her legs for gangrene secondary to poor perfusion. After a long hospitalization, she was transferred to a rehabilitation facility where she was fitted with prosthetic legs. Sonia quit her job to stay with Isabella throughout her illness and recovery. When Sonia quit her job, her insurance benefits ended, and she could not afford to pay for continuing insurance coverage.

Questions: Discuss all of the questions below:

• Isabella's health care bills were enormous.
• What is the role of the nurse in containing these costs?
• Do you think Sonia should have continued working through Isabella's illness in order to continue insurance coverage?
• How could/does the active involvement of people/families improve cost effectiveness and quality of care?
• Would you feel differently about who is accountable for paying the bills for caring for this person if the person had been a morbidly obese adult who lived with unhealthy eating and exercise habits?
• Do you feel that health literacy played a role in the person's outcome? If so, how?
• How could each of the following nursing roles advocate for Isabella: educator, manager, researcher, activist?
• Share how you value seeing this situation through the eyes of Isabelle or Sonya and how you can respect and encourage people/families to share their values, preferences, and needs.
• How could the contemporary care delivery model of person-centered care, used by an interdisciplinary team, empower Isabelle and Sonya and effect the care and outcomes for Isabella?
• What is the RN's role on the interdisciplinary team?
• What limits do you see in the ability to provide person-centered care for Isabelle?
• Discuss these questions as well:
• You are a nurse working in this rehabilitation facility. You have a peer in this facility who disagrees with your feelings about Isabella's current employment decisions. This peer makes derogatory, demeaning statements about your feelings for this situation.
• Is this a display of incivility?
• If so, what are some possible destructive consequences of this incivility, including the financial implications for the person and rehabilitation facility?
• As a nurse on the team, what can you do to resolve conflict and/or create consensus within a team?