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Apr 19, 2024

Assignment Task

Aim

In this assessment item you will have the opportunity to demonstrate your knowledge and understanding of the concepts of equity, access, health literacy and advocacy in relation to people living with a disability. Reflection enables nurses and student nurses to develop their nursing practice by reflecting on their knowledge, experiences, feelings, beliefs, and actions.

Task Description

For this task you need to write a word structured reflection using Driscoll’s Model of Reflection1 . In your reflection you will systematically and critically reflect on what you have learned about the lived experience of people with a disability and barriers to accessing community support services to meet their needs. You will also reflect on your own experience and attitudes to disability in the context of providing person centred and culturally safe nursing care.

Introduction

Provide a short introduction of topics to be covered in the reflection

What Describes the context and circumstances?

  • Briefly introduce Liz and Deb and describe their experience of living with a disability?
  • Describe the main felt needs that Liz and Deb highlight?
  • Explain how these felt needs might be met through Australian Government National?
  • Disability Insurance Scheme funding, and describe some of the challenges they experienced in navigating the process of applying for support through the NDIS?

Reflect and analyze

  • With reference to scholarly literature and using examples from the assignment learning materials, discuss at least three (3) equity and access barriers to healthcare and supportive services for people living with disability?
  • Describe a personal or professional experience of living with or caring for an individual with a disability, and discuss how this experience has influenced your attitude (thoughts and beliefs) about people living with disabilities?
  • With reference to scholarly literature, discuss the link between nurses’ attitudes to disability and effective delivery of person-centred care?

Learning and implications for practice

When delivering person centred nursing care as a nursing student, discuss three (3) examples of actions/interventions you can implement to assist in better meeting the health needs of people living with a disability?

Explain three (3) important concepts/principles about caring for people with a disability that you have learned from completing this assessment task, and use examples to illustrate how you will apply this knowledge in your future practice as a Registered Nurse?

Liz and Deb’s Story

Liz is a 48-year-old woman and Deb (46 years old) is her spouse. Liz and Deb immigrated from Canada to Brisbane 10 years ago. They have made many good friends in Australia, and Deb’s brother and mother who live in Sydney visit once or twice a year. Liz’s family all live in Canada. Liz and Deb own their two-story house and car.

Two years ago, Liz had a right cerebro-vascular accident (CVA) and was hospitalised for several weeks. Liz has been left with an ongoing disability related to the CVA, which has had a profound impact on both Liz and Deb.

From Liz’s perspective experiencing a CVA at a young age has been quite devastating. There was the initial shock of being diagnosed with a stroke, with the loss of mobility, speech and cognitive function and the need for acute hospital care and loss of independence. Liz feels her initial care was less than optimal, it was during Covid and she wasn’t transferred to a specialist stroke rehabilitation ward where rehabilitation could start immediately. When she was ready for discharge, there was no discharge planning regarding home modification or rehabilitation supports. For example, their house has internal stairs up to the bedrooms and there was no discussion or planning as to how Liz would manage this when sent home. While Liz’s condition has improved over the last two years with specialist rehabilitation, she still has a range of ongoing health issues and challenges.

Liz’s mobility is still impaired, and while she can walk short distances with a walking stick her balance is not good, making her susceptible to falls and she has difficulty walking in shopping centres and outdoors. Liz also gets physically and mentally fatigued very quickly and her speech, cognitive function and concentration while much improved, is still not what it was prior to the CVA. Liz has not been able to work since her CVA and feels quite socially isolated not being able to drive herself or participate in activities that she used to enjoy. Her mental health and sleep has really suffered and she experiences bouts of depression and sadness about her health. Liz is very grateful for the love and support of Deb but knows that Deb is getting ‘carer fatigue’ and worries about her.

From Deb’s perspective Liz having a CVA has also been incredibly difficult to witness and life-changing for both of them. Deb was initially told that Liz would make a full recovery, but two years on Liz is still needing a lot of support and the realisation that Liz has a long-term disability is quite overwhelming at times. Initially Deb was able to take some leave from her busy job, but now as the sole earner, she has had to return to work as her leave has ended. She is lucky that in her job she can mostly work from home, so is able to be to be at home to assist Liz when needed. Deb’s job is high pressure and very mentally demanding, she feels that her work has suffered and she is feeling really exhausted. Deb has said that it has now got to the point that she needs some assistance and support in caring for Liz to make their quality of life better.

Both Liz and Deb describe their experiences with the health system and some health care providers as being very challenging, and at times, quite distressing. When Liz was first in hospital some nurses were great and seemed to really care and be concerned about her, but others would just come in and do a blood pressure or give medications and walk out. Some didn’t introduce themselves or talk to Liz about her condition or how she was feeling, they often didn’t offer help with mobility or meals and that made her feel like a burden when she had to ask for help. Once Liz was being moved to another ward in the middle of the night the nurse came in and told her to get up and pack her things up, even though Liz couldn’t get out of the bed unassisted and was woken from a deep sleep. On another occasion during medical rounds, a health professional asked Deb to leave the room, not recognising or considering that Deb was Liz’s spouse and wanted to be included in discussion about her condition.

For the last two years since Liz’s CVA, Liz and Deb have not had any home assistance or community care. After they heard about the NDIS, they asked both their GP and the Neurologist about the NDIS scheme, asking if they should apply. They were told Liz was not eligible which was confusing given the online information they had read about the NDIS. Even though they have a high level of health literacy they really weren’t sure who else they could get good advice from about eligibility or assistance with preparing an application. They discussed this with a family friend who works for Queensland Health, who was able give them contact details for an Adult Community Disability Nurse Navigator John. When they contacted John, he then referred them to an Occupational Therapist (OT) Jenny who has expertise in supporting people to prepare NDIS applications. Having now met with OT Jenny, they have been told that Liz is definitely eligible to apply. Jenny is assisting them to complete the application and also to organise all the required assessment information to go with the NDIS application. While this process has been very time consuming and stressful they are very grateful for the help and support they have finally received to prepare a strong application.

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