Explain the SOME of the caritas processes and discuss where and how they relate to the clinical reasoning cycle in the scenario 

Question Details

From the case scenario provided below, please answer the following questions:

1. Identify & explain the key aspects of the clinical scenario

2. Explain the SOME of the caritas processes and discuss where and how they relate to the clinical reasoning cycle in the scenario 

• write up to the“establish goals” step of the Clinical Reasoning Cycle (CRC)
• Don’t need to discuss all 10 Caritas Processes. Only discuss the Caritas Processes that are relevant/ would apply to each part of the CRC. Discuss the most important ones
• Eg. For step 1 of the CRC – Consider the patient’s situation, which processes will you apply to do this effectively? Embracing humanistic-altruistic values by practice of loving-kindness, compassion and equanimity with self/others – as we need to connect, listen receptively, accept others. You could also look at number 2, 4 and 5 etc. Establish goals and take action would use Process 6 – using creative scientific problem-solving methods for caring decision-making and creative solution-seeking.

3. Explain how the caritas processes and clinical reasoning cycle could be used to achieve solutions to address the care needs for Shawn 

•  implementing the goal/s  identified in Q2.
• how to implement the goals  set/identified in Q2 to help Shawn. Think about what interactions a nurse might do, what caritas processes are being used? The focus is on the caritas processes.
•  eg – one of the goals may be to help Shawn with his substance abuse. So in Q3,  look at how to help Shawn from a Caritas Perspective. eg. research substance abuse rehabilitation from a caring theory perspective, or caring science and drug programs or nursing ect…. With this information, discuss  plans including the Caritas Processes that are relevant to the discussion.
• From the scenario, identify some solutions that could be applied (this is the CRC part- setting goals) and what Caritas principles could be used to achieve them…
• setting goals/evaluating/reflecting section of the CRC.

CASE STUDY

You are the nurse caring for Shawn on the morning shift.

Shawn Bolton is a 25 year old male who self presented to ED with fevers (temp of 39^oC). He has an infected abscess on his left arm from injecting heroin. He has been admitted to your ward for observation and prescribed IV antibiotics.

Shawn was released from prison six week ago for a drug related offence. He was released without accommodation, support or money and has been sleeping rough.

Due to Shawn’s drug use and criminal history, some nurses on your ward are reluctant to care for Shawn. One nurse said they hope he discharges himself so someone more deserving can have his bed.

The handover from your night shift colleague said Shawn didn’t sleep at all last night. He’s highly agitated, complaining of severe stomach cramps, demanding pain relief and wants a cigarette.

Your colleague said Shawn swore when told he was only charted paracetamol for his pain and the hospital had a no smoking policy. Shawn was told his behaviour was inappropriate and your colleague walked out the room to let him calm down. Staff on your ward have been told to limit contact with him because of his drug seeking behaviour and criminal record. Security has been notified and will monitor his behaviour.

Although you are not sure what’s happening with Shawn, based on the handover, you are concerned about heroin withdrawal and his risk of endocarditis.

(The following shortened clinical scenario is taken from Goodhew, M., & Robinson, T. (2023). Caring for a person with substance dependence and complex post-traumatic distress syndrome. In T. Levett-Jones (Ed.), Clinical reasoning: learning to think like a nurse (3^rd ed., pp. 190-191). Pearson Australia.

Question Guide (Order for Complete Paper)

1. Key Aspects of the Clinical Scenario:
   • Patient: Shawn Bolton, a 25-year-old male.
   • Presenting Complaint: Infected abscess on his left arm from injecting heroin, with a fever.
   • Background: Recently released from prison, homeless, and with a history of drug-related offenses.
   • Nursing Staff Attitudes: Some nurses are reluctant to care for Shawn due to his drug use and criminal history.
   • Current Symptoms: Agitation, severe stomach cramps, demanding pain relief, and wanting a cigarette.
   • Treatment: Prescribed IV antibiotics.
   • Concerns: Possible heroin withdrawal and risk of endocarditis.
2. Caritas Processes in the Clinical Reasoning Cycle: a. Step 1: Consider the Patient’s Situation
   • Caritas Process 1: Embracing humanistic-altruistic values by practicing loving-kindness, compassion, and equanimity with self/others. This relates to the need to connect with Shawn and understand his background without judgment.
   • Caritas Process 2: Being authentically present and enabling faith and hope. Building trust and rapport with Shawn is crucial.

   b. Step 2: Collect Information

   • Caritas Process 3: Cultivating one’s own spiritual practices and self-reflection. Nurses can reflect on their biases and judgments regarding Shawn’s history and drug use.

   c. Step 3: Process Information

   • Caritas Process 6: Using creative scientific problem-solving methods for caring decision-making and creative solution-seeking. This relates to the need to assess and plan Shawn’s care holistically, considering his physical and emotional needs.

   d. Step 4: Identify Problems or Issues

   • Caritas Process 4: Developing and sustaining a helping-trusting, caring relationship. Building trust with Shawn is essential to address his issues effectively.
3. Using Caritas Processes and Clinical Reasoning Cycle to Address Shawn’s Care Needs: a. Goal 1: Provide Holistic Pain Management
   • Implementation: Ensure that Shawn’s pain is managed effectively by assessing his pain level, addressing his severe stomach cramps, and considering alternative pain relief methods.
   • Caritas Process: Caritas Process 4 (Building trust and rapport) is crucial here, as Shawn’s trust in the nursing staff is essential for effective pain management.

   b. Goal 2: Address Heroin Withdrawal

   • Implementation: Collaborate with an addiction specialist or counselor to assess and manage Shawn’s withdrawal symptoms. Provide emotional support and education on withdrawal.
   • Caritas Process: Caritas Process 1 (Embracing humanistic-altruistic values) and Caritas Process 6 (Creative problem-solving) are relevant. Compassion and problem-solving are essential to address withdrawal.

   c. Goal 3: Assess for Endocarditis Risk

   • Implementation: Perform a thorough assessment to determine Shawn’s risk of endocarditis, including monitoring vital signs, ordering relevant tests, and consulting with an infectious disease specialist.
   • Caritas Process: Caritas Process 6 (Creative problem-solving) and Caritas Process 3 (Self-reflection) are applicable. Critical thinking and self-reflection are important for Shawn’s well-being.

   d. Goal 4: Build a Supportive Environment

   • Implementation: Advocate for Shawn’s social needs, including housing and support services. Collaborate with social workers and community organizations.
   • Caritas Process: Caritas Process 2 (Being authentically present) and Caritas Process 4 (Building trust) play a role in creating a supportive environment for Shawn.

   e. Goal 5: Address Nursing Staff Attitudes

   • Implementation: Conduct staff education on stigma, bias, and addiction. Promote a culture of empathy and understanding.
   • Caritas Process: Caritas Process 3 (Self-reflection) and Caritas Process 9 (Instilling faith and hope) can guide staff attitude improvement.

By integrating the Caritas Processes with the Clinical Reasoning Cycle, the nursing care for Shawn can be more compassionate, effective, and patient-centered, addressing both his physical and emotional needs.