CMCT01_Case_Studies 2015

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CASE STUDY 21 – ELIZABETH

Elizabeth is a 50 year old nurse who was involved in a work place injury involving her knee being stuck in between a bed and a trolley in a hospital lift. This involved a patient who was an ‘Ice Addict’ and it took five people to free her from this situation. Her rehabilitation plan has included a fitness plan, post knee replacement and counselling for the post traumatic stress she has experienced as a result of the ordeal. She has not always being compliant with her appointments and exercises. When Elizabeth visited the Occupational Physician for an assessment and expert opinion she was not happy with his attitude nor report and subsequently made a written complaint to the Health Care Complaints Commission. Her actions and behaviour indicate an unreasonable obsession in regards to this complaint. Elizabeth has told you that her work is her life. She previously used to breed and show her prize winning labradoodles but due to her injury she is no longer able to participate in this physically demanding hobby. Elizabeth lives alone and has become increasingly reclusive and no longer goes out socially with her friends nor returns their calls. She has been diagnosed with claustrophobia and suffers from increasing anxiety resulting in regular panic attacks which have required attendance by paramedics at her home. Elizabeth refuses to get into a lift and will not attend your meetings in your office which is on the 6th floor making her rehabilitation plan challenging. As the case manager you have arranged for her to return to work 3 hours per day 5 days per week. You receive feedback from the workplace that Elizabeth is not ‘getting on’ with others, that she talks about her case to both staff and patients and complains about you, the organisation and the system at length. When you speak to Elizabeth she denies ever discussing her case, calls you “a liar and a bully” and accuses you of being ”incompetent” and “out to get her”. She exclaims that she has “had enough” and is thinking of going to A Current Affair about the whole situation as she feels she is being unfairly treated. Questions: 1. What guidelines from each of the CMSA National Standards of Practice for Case Management would you utilise in this case? 2. How does your proposed case management provide evidence of: A. Facilitating the personal development of Elizabeth? (i.e. her individual, diverse and special needs, including her aspirations, choices, expectations, motivations, preferences and values) B. Advocating for Elizabeth’s rights? (including developing Elizabeth’s strengths to advocate for herself) C. Addressing Elizabeth’s needs? (i.e. purposeful case management) D. Promoting sustainable solutions for Elizabeth? (i.e. balances Elizabeth’s needs with the available resources and any of your possible limitations as a case manager) E. Effective communication? (i.e. with Elizabeth and all other Key Stakeholders) Instructions: 1. Please answer each of the questions below. 2. Please complete this activity with reference to the resource materials provided. 3. Please document and report your findings back to the group.

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