Potential Impact of Chronic Illnesses – Nursing Assignment Scenario: Ethan is a 52-year- old…

Potential Impact of Chronic Illnesses – Nursing Assignment

Scenario:
Ethan is a 52-year- old dairy farmer from regional Victoria. He lives in the house within his farm, 30 kms from the nearest town, with his partner, Alma, and their 25-year- old son, Noel. His son works with him at their farm. Ethan left school at the age of fifteen so that he could work at the farm which was then managed by his parents who have since died. His father died at the age of 57 due to cardiac complications following an abdominal hernia repair surgery. His mother died at the age of 62 from metastatic breast cancer. After his parent’s deaths, Ethan had to take out a substantial mortgage in order to buy out his sister from her share of their parent’s estate.

Alma had been working as a teacher’s aide in the nearest town but was made redundant last year when school enrollments fell. She has been unable to find another job as yet. Alma has been diagnosed with depression by their local GP and is taking medication. Ethan recently suffered an acute myocardial infarction and has been discharged back home from the large acute hospital in a regional city 70 minutes’ drive from their farm property. He is overweight with a distinctive ‘beer belly,’ smokes 2 packs of cigarettes each day, drinks alcohol (usually between 1 to 2 bottles of beer) daily and only sporadically takes his antihypertensive medication. He occasionally takes mild analgesics to manage an ongoing lower back pain and “dodgy knees”, he states the local GP had said that this is the “wear and tear” of his back and knees related to working in the farm and playing football in his younger years. He has also been referred to the respiratory clinic as it is suspected he has constantly recurring bronchitis and early stages of emphysema.

Ethan reported that the acute myocardial infarction occurred during a heated argument with Alma. He initially blamed her for all of his problems and it has been reported he initially refused to cooperate with hospital staff. However, he found out during the hospitalisation that it was caused by the partial blocking of one of the arteries of his heart with fat deposits. He agrees that he would benefit from a cardiac rehabilitation program but
given the distance from the hospital and the demands of the work at the farm, he openly declares that he is likely to be non-compliant to a centre- based program. He says that he really needs to be able to look after the cows himself because he does not think Alma would do it and he feels that it is unfair to impose such a big role on his son.

Part One:
What are the chronic illnesses that Ethan is likely to have? Explain your answers using the information from the scenario. Describe the potential impact on Ethan and his family if he was to be formally diagnosed with the illnesses you’ve identified. Support your discussion with relevant literature.

Part Two:

What model of care would suit Ethan’s needs? Explain your answer using information from the scenario. Describe the process that needs to happen to establish this model. Support your discussion with relevant literature.

Part Three:

Consider the scenario that Ethan agreed to the service model you have proposed in question two. You now ill need to write down your nursing letters:

First, write a patient communication letter addressed to Ethan to let him know of the plans you both agreed on. Give a brief background to remind him of why we are doing this, tell him what the plans are, and let him know what actions are needed of him.

Second, write a referral letter to one of the services that would be beneficial for Ethan to access. Give them the part of Ethan’s background that is relevant to their service, let them know what service you wish for them to provide and provide them with details that you feel will be useful (such as time frames and means for coordination).