Go to Omaha System Case Studies: The case studies are listed at the bottom of the page (Emma, Janice, Francis, Bill, John, Julie, Tamika, or Joe). Choose one of the case studies and use your textbooks and other resources to answer the following questions: 1. What key criteria will the PHN need to consider for a successful first visit? 2. How will the PHN establish and maintain professional boundaries? 3. What is an ethical challenge that the PHN may encounter with the client? 4. How does the scope of PHN practice guide the responsibilities of the public health nurse in the chosen case study? 5. Identify key communication skills to assure respectful interaction with the client. 6. Describe the components of the nursing process in the planned home visit? 7. Identify components of a Family Assessment that could be used to assess this individual/family (refer to Family Assessment tools used in Nurs 362). 8. Identify priority problems for this individual/family. 9. Identify a plan and nursing interventions for this individual/family. Expand on what was written in the case study.

Case Study: Emma

1. Key criteria for a successful first visit:
In order for the public health nurse (PHN) to have a successful first visit with Emma, several key criteria need to be considered. Firstly, the PHN should ensure that they have thoroughly reviewed Emma’s medical history and background information prior to the visit. This includes any relevant medical conditions, medications, and recent healthcare services received. Understanding Emma’s medical background will assist the PHN in tailoring their assessment and interventions to her specific needs.

Additionally, the PHN should prioritize establishing a rapport with Emma during the first visit. This involves actively listening and showing empathy towards Emma’s concerns and needs. It is important for the PHN to create a safe and non-judgmental environment where Emma feels comfortable discussing her health-related issues.

2. Establishing and maintaining professional boundaries:
Maintaining professional boundaries is crucial for the PHN in their interactions with Emma. Firstly, the PHN should clearly communicate the purpose and goals of their visit to Emma, ensuring that there is no confusion about their role. It is important to delineate between friendship and the professional relationship to avoid any potential ethical dilemmas.

To establish and maintain professional boundaries, the PHN should maintain a professional demeanor, dress appropriately, and avoid sharing personal information that is not relevant to Emma’s care. Additionally, the PHN should not engage in dual relationships, such as becoming friends with Emma outside of the professional context.

3. Ethical challenge that the PHN may encounter:
One ethical challenge that the PHN may encounter while working with Emma is the issue of confidentiality. As a healthcare provider, the PHN has a duty to protect Emma’s personal health information and maintain confidentiality. However, if the PHN becomes aware of any potential harm or abuse to Emma or others, they have an ethical responsibility to report it to appropriate authorities.

Balancing the need to protect Emma’s privacy while also ensuring her safety and well-being can be challenging. The PHN should ensure that Emma understands the limitations of confidentiality and the circumstances in which information may need to be shared without her consent.

4. Scope of PHN practice and responsibilities:
The scope of PHN practice guides the responsibilities of the PHN in this case study. As a PHN, their focus is on promoting and preserving the health of individuals, families, and communities. In Emma’s case, the PHN’s responsibilities may include conducting health assessments, providing health education and counseling, coordinating care and referrals, and advocating for resources and services that meet Emma’s needs.

The PHN may collaborate with other healthcare professionals and community organizations to ensure comprehensive care for Emma. They should also stay up-to-date with current evidence-based practices and guidelines to provide the best possible care within their scope of practice.

5. Key communication skills for respectful interaction:
To assure respectful interaction with Emma, the PHN should utilize key communication skills. Active listening, empathy, and non-judgmental attitudes are essential in building trust and understanding with Emma. The PHN should be attentive to Emma’s verbal and non-verbal cues, allowing her to express herself fully.

Clear and concise communication is also important, ensuring that information is conveyed in a manner that is easily understandable to Emma. The PHN should use plain language and avoid using medical jargon or terminology that may confuse or intimidate Emma.

Lastly, the PHN should practice cultural sensitivity and respect for Emma’s values and beliefs. Recognizing and valuing diversity is crucial to providing client-centered care.

6. Components of the nursing process in the planned home visit:
During the planned home visit, the nursing process includes several components. Firstly, the PHN will perform a comprehensive assessment of Emma’s physical, psychological, and social health. This includes gathering subjective and objective data, such as Emma’s reported symptoms, vital signs, and observations of her living environment. The assessment will inform the PHN’s understanding of Emma’s health status and guide subsequent interventions.

After the assessment, the PHN will identify any potential nursing diagnoses or problems. These can be derived from analysis of the assessment data, and they provide the basis for developing a plan of care. Nursing interventions will then be implemented to address the identified problems, promote health, and prevent complications. The PHN will continuously evaluate the effectiveness of the interventions and make any necessary adjustments.

7. Components of a Family Assessment:
In order to assess Emma’s individual/family situation, several components of a Family Assessment can be used. Family assessment tools used in Nurs 362 can serve as a guide. These tools include evaluating the family’s structure, roles, and dynamics. Assessing Emma’s family support system, including her relationships with family members and the level of involvement or assistance they provide, is important. The PHN will also assess the family’s strengths, resources, and coping mechanisms to determine their ability to support Emma’s health.

Furthermore, the assessment should include an evaluation of the family’s cultural and socioeconomic background, as these factors can significantly influence health-related beliefs, behaviors, and access to healthcare resources.

8. Priority problems for Emma:
Based on the case study, some priority problems for Emma may include managing chronic health conditions such as diabetes and hypertension, addressing medication adherence, and promoting lifestyle changes to improve her health outcomes. Emma’s mental health may also be a priority concern, as she has been feeling depressed and isolated. Obesity and its associated risks can be another priority problem to address.

9. Plan and nursing interventions for Emma:
Considering the outlined priority problems, a plan of care and nursing interventions can be developed for Emma. The plan should focus on promoting self-management of chronic conditions through education on medication management, nutrition, and physical activity. The PHN can collaborate with Emma to set achievable goals and develop strategies that fit her individual needs and preferences.

To address Emma’s mental health concerns, the PHN can explore referral options for counseling or support groups. They can also provide emotional support and encouragement during home visits. Additionally, the PHN can facilitate social connections for Emma by connecting her to community resources and programs relevant to her interests.

Regarding obesity, the plan may include dietary modifications and physical activity recommendations. The PHN can engage Emma in goal-setting and monitoring her progress. Collaboration with a registered dietitian or other relevant professionals may be necessary to develop a comprehensive plan for addressing obesity and promoting overall well-being.

In summary, the first visit with Emma requires careful consideration of key criteria, establishing and maintaining professional boundaries, anticipating ethical challenges, understanding the scope of PHN practice, utilizing effective communication skills, implementing the nursing process, conducting a family assessment, identifying priority problems, and developing a plan of care with appropriate nursing interventions.