Case Presentation Melanie is a

Case Presentation

Melanie is a 4-year-old girl with cystic fibrosis and developmental delays. She is from a small rural community. Melanie is currently hospitalized at a large tertiary care center for a “tune-up” consisting of vigorous chest physiotherapy and antibiotics. Kayla is an experienced registered nurse mentoring Janelle, a new graduate nurse who has not worked with patients with cystic fibrosis. Together they are working with Melanie’s parents on a nursing plan of care during the hospitalization. The Child Life program has also been included in Melanie’s plan of care to ensure developmental appropriateness for Melanie’s hospital experience.

The pediatric pulmonary team (consisting of the pulmonologist, social worker, nutritionist, nurse practitioner, and nurse educator) meets with Melanie’s parents and the pediatric unit nursing staff to discuss the need for a gastrostomy tube because of Melanie’s poor weight gain and past aspiration episodes. Via telehealth modalities, Melanie’s primary care provider, a pediatric nurse practitioner from Melanie’s hometown, joins the team conference. Kayla has also linked Melanie’s family with a parent advocacy group and has invited a representative to be present at the meeting to ensure understanding of the presented information. Melanie’s parents ask many questions regarding the gastrostomy tube placement. The questions are met with open, honest answers using evidence-based information as appropriate. Joint decision making occurs with agreement to have the surgery scheduled. At the end of their shift, Kayla and Janelle handoff information to the oncoming nurse at Melanie’s bedside. The parents are present to hear and contribute to the report and plans for Melanie’s care. Kayla and Janelle leave work feeling a sense of joy and accomplishment.

Case Analysis Questions

 1. Reflecting on the scope of the concept, what type of opportunities for collaboration are evident in this case?

2. Which aributes of collaboration are apparent in this case?

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