Primary health care for type 2 diabetes, Other Subject

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Mary who, 42, lives with husband and 5 children aged 5 to 18. Mary had an Italian father and an aboriginal mother and was born and lives in remote western Queensland all her life. Currently she lives 25kms outside a town of only 2800 people. In the town, there is only a 10 bed hospital. The nearest larger hospital is 500km away, and the nearest tertiary hospital is 1000km away by road. The flying doctors service visits the area if called in an emergency and to do some specialist clinics.

Mary has just been in the tertiary hospital for tests and stabilisation of her type 2 diabetes after being transferred from her local hospital. The team involved with Mary in the tertiary hospital include the diabetic educator, RN's, dietician, social worker and doctor.  Once home the team involved in her care at the local hospital include the doctor, RN, EN only.

1. Outline the levels of health care involved in Mary's case and also the primary health care initiatives that could have possibly prevented her admission to hospital and could prevent further admissions to hospital.

2. Identify the potential risks to the implementation of the primary health care strategies you have chosen to assist Mary and her family.

3. Explain your role as an EN within the teams that are assisting Mary's recovery and future maintenance of health.

4. In your explanation of care and support offered to Mary, identify the models of wellness and illness that can be applied, and the issues that may arise and how the EN can provide appropriate care.

Your interested in applying for work in the remote hospital where Mary attends when she's home.

5. Identify the changes in the health system that has contributed to the downsizing of country hospitals and the move to specialisation of care in tertiary hospitals.

6. Outline the educational preparation of nurses who wish to work in rural and remote health services and the professional nursing bodies that can support the nurses in these environments.

7. Describe how you can find work opportunities in rural and remote Queensland. Identify the skills required for the job and your current level of skill development.

8. Explain the scope of practise for an EN in rural remote areas, the reason that the scope may be different than in a tertiary hospital and how your scope of practise may change in various contexts.

Whilst you are employed at the remote hospital Mary receives news she is dying and the grieving process is evident with her and her family.

9. Outline how you can access support services and develop a learning program for Mary as her condition deteriorates.


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