Case scenario analysis

Case Study

Shona is a 42 years old, married lady who has three children, works as a medical secretary all week and likes to be with her family on weekends. Her elderly parents were living close to her home until recently when her father died and her mother, whose health is frail, moved to an assisted living arrangement an hour’s drive away. Shona’s husband works long hours and she finds it stressful keeping up with the care of her children and attending to her mother, as well as working full-time. She attends Yoga classes three times per week when she can find the time. She had “a bit of a scare” two weeks ago when she was hospitalized for two days for investigations after experiencing chest pains. Shona has returned to the emergency department experiencing chest pain.

The following is the conversation between Shona and the nurse:

Nurse:   Why are you here, Shona?

Shona:  I’ve been having pains and tightness in my chest all day.

Nurse:   So, you think you are having a heart attack?

Shona:  I don’t know. Is that what it could be?

Nurse:   You are probably just upset about your Mum and Dad.

Shona:  I don’t think so. I am missing my Dad and I am so worried about Mum and all she has had to go through since Dad died.

Nurse:   It seems like you’ve been having a stressful time.

Shona:  Yes, and it’s not getting better.

Nurse:   Can you explain that further?

Shona:  My husband is out-of-town on business and I had to call his mother to look after the kids while I came here.

Nurse:   Couldn’t he have come home when he heard you weren’t feeling well?

Shona:  I haven’t told him yet. I wanted to find out what is happening first.

Nurse:   It’s likely all of the stress that’s making you ill. I believe you should talk with a counsellor.

Shona:  Well, shouldn’t we wait to see what the doctor says?

Nurse:   Well, I have been here for years and I know much more than these doctors. And I am your nurse and I’m telling you it’s most likely stress related. You are anxious aren’t you?

Shona:  I suppose I get anxious if I’m worrying about Mum. I also get sad when I think of my Dad.

Nurse:   Grief is a difficult challenge to deal with. How are you doing with that?

Shona:  One minute I think I am OK then, suddenly I could just cry and cry. I miss him so much.

Nurse:   It’s best not to think about that and focus on happy things like your children.

Shona:  I guess so, but I can’t block it out.

Nurse:   Maybe you’re depressed.

Shona:  I’m not depressed! I’m grieving! Am I not allowed to grieve?

Nurse:   You are right. I am sorry that I said that.

Shona:  Thank you. I think I would like to talk to the doctor now.

Nurse:   I will go get the physician on shift.

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