Andy is a second year student nurse on his 4th clinical placement. His mentor has asked him to begin the admission of a new patient, Miss Phillips.
Miss Phillips is a very frail looking 88 year old lady who had a fall at home during the night. She lives alone and was found on the floor in the morning by her neighbour Mrs James who had called by to see how she was feeling. She has recently had a chest infection and some of her neighbours have been helping out with shopping and making a few meals as Miss Phillips has no family. She appears quite confused and disorientated. Andy notices that she has sustained considerable bruising to her left arm. Andy’s mentor asks him to make sure that he places an air mattress on Miss Phillips bed.
Earlier in the shift Andy had been helping Mr Singh with his morning wash when he noted that his right heel looked very sore with a water filled blister about the size of a 50p piece. Mr Singh is one of the younger patients. He is 62 and has been on the ward for about a week. He was admitted with chronic diarrhoea following a recent trip overseas to attend a family wedding. Andy has grown fond of Mr Singh, making time for small conversations throughout his shifts to try to cheer him up as Mr Singh feels lonely in his side room. Mr Singh has been worrying about his diabetes, he normally manages this well but it has been less stable since his illness and he has been losing weight. Nursing staff have explained to him that once his diarrhoea clears he will be able to walk around the unit and get to know some of the other patients. Andy is concerned that Mr Singh is feeling isolated, anxious and withdrawn, he is sleeping for much of the time and now appears to be developing a pressure sore on his heel.
When Andy goes to collect a mattress for Miss Phillips he notices that there is only one air mattress remaining. The community unit does not have recourse to equipment from other sources and it could take a few weeks to obtain an additional mattress. Andy is concerned that Mr Singh also needs an air mattress to prevent him from developing further pressure areas. He returns to the ward to ask his mentor who should have the mattress.
A case by Helen Jones ( VX Community )
It is proposed that Miss Phillips is given the last air mattress.