Trauma Patient

Case Study: Trauma Patient

Mary Nelson is a 30-year-old divorced female who lives in the suburbs with her 7-year-old son, Robert, and her 60-year-old widowed mother. She is employed full time as a legal secretary.

She was driving home from work one evening when a car crossed into her lane and hit her car head-on. Ms. Nelson was taken by helicopter to the nearest trauma center, where she was stabilized and treated for multiple injuries. Her mother, Mrs. Richards, was listed as her emergency contact and was contacted. Diagnostic tests confirmed fractures of her left ulna (arm) and left femur (leg). Her jaw was severely fractured, she lost most of her teeth, and her left hand was crushed. She also experienced a concussion.

 

Ms. Nelson was admitted to the hospital’s trauma unit. She underwent multiple surgical procedures to repair her many fractures. She has been in the trauma unit for several weeks. Her fractures are healing well, and her condition is stable. Her pain control is good on oral pain medication.

Ms. Nelson has lost weight since admission. Her jaw is wired shut to promote healing, and, although she is receiving high-calorie liquid supplements by mouth, she does not like their taste. Her mother often brings milkshakes, which she enjoys; however, she does not have much of an appetite.

Mary Nelson has limited mobility due to her fractured femur. She also has difficulty moving her left arm and hand, with limited fine motor coordination and movement. The extent and permanency of these limitations are not yet known.

Ms. Nelson has a verbal communication impairment related to her jaw being wired shut. She occasionally gets frustrated when people cannot understand her. She is left-handed and cannot write due to the injury to her left hand.

Ms. Nelson hopes that she will return to full functioning. She actively participates in decision making about her care. Her cognition is intact. She is experiencing some shortness of temper and occasional mood swings since her accident and states she has no patience anymore.

Ms. Nelson’s mother, Mrs. Richards, is caring for her son, Robert. Mrs. Richards and Robert visit frequently. Robert is worried about his mother, and his schoolwork is suffering.

 

Discussion Questions

1. List the members of the interprofessional team, including family members, who could be engaged in Mary Nelson’s case to provide comprehensive care and meet her many needs.
2. Explain the roles and responsibilities of each team member in providing Mary Nelson’s care.
3. Identify overlapping skills, and develop a strategy to clarify and assign responsibilities so that there is no duplication of services.
4. Using the same strategy as in question 2 explain how the team works together to provide care.
5. How does each professional’s expertise contribute to the team to optimize Mary Nelson’s care?

1. Members of the interprofessional team and family members who could be engaged in Mary Nelson’s case to provide comprehensive care and meet her many needs include:

• Mary Nelson (the patient)
• Mrs. Richards (Mary’s mother and emergency contact)
• Robert (Mary’s 7-year-old son)
• Trauma surgeon
• Orthopedic surgeon
• Maxillofacial surgeon
• Neurologist
• Nurses (including trauma nurses, orthopedic nurses, and nursing assistants)
• Physical therapist
• Occupational therapist
• Speech-language pathologist
• Dietitian
• Social worker
• Case manager
• Psychologist or psychiatrist (for addressing mood swings and emotional well-being)
• Primary care physician (for long-term care coordination)
• Radiologist (for diagnostic imaging)
• Pharmacist (for medication management)

2. The roles and responsibilities of each team member in providing Mary Nelson’s care are as follows:

• Trauma surgeon: Oversees the overall medical care, coordinates surgical procedures, and monitors her general condition.
• Orthopedic surgeon: Manages and performs surgeries related to fractures in the ulna and femur.
• Maxillofacial surgeon: Addresses jaw and dental injuries.
• Neurologist: Manages and monitors her concussion and any potential neurological complications.
• Nurses: Administer medications, monitor vital signs, provide wound care, and assist with daily activities.
• Physical therapist: Helps Mary regain mobility and strength, especially in her fractured femur.
• Occupational therapist: Assists with regaining fine motor skills and hand functionality.
• Speech-language pathologist: Helps with communication strategies while her jaw is wired shut.
• Dietitian: Assesses her nutritional needs and develops a plan to address weight loss.
• Social worker: Provides emotional support and connects Mary with resources and services for her and her family.
• Case manager: Coordinates care, communicates with various team members, and ensures a smooth transition between different phases of care.
• Psychologist or psychiatrist: Addresses mood swings, emotional well-being, and any psychological distress.
• Primary care physician: Ensures continuity of care and manages her overall health beyond the hospital stay.
• Radiologist: Provides and interprets diagnostic imaging.
• Pharmacist: Manages medication regimens, including pain control and supplements.

3. To prevent duplication of services, overlapping skills among team members should be identified and responsibilities clarified as follows:

• Nursing staff: While all nurses are responsible for basic patient care, they should communicate with each other and other specialists to ensure comprehensive care and prevent duplication.
• Physical therapist and occupational therapist: Collaborate on rehabilitating Mary’s mobility and hand function, ensuring that their treatment plans are coordinated.
• Speech-language pathologist: Communicates with other team members to provide input on dietary requirements and jaw healing progress.
• Social worker and case manager: Collaborate on addressing psychosocial and logistical aspects of Mary’s care to prevent redundancy.

4. The interprofessional team works together to provide care by maintaining open lines of communication, holding regular interdisciplinary meetings, and sharing patient information and progress updates. They collaborate on treatment plans, set goals, and ensure that each aspect of Mary’s care is addressed comprehensively and efficiently. This teamwork helps avoid duplications, fills gaps in care, and ensures that Mary’s needs are met holistically.
5. Each professional’s expertise contributes to the team to optimize Mary Nelson’s care as follows:

• Trauma surgeon ensures the overall medical stability of the patient.
• Orthopedic surgeon addresses fractures and mobility issues.
• Maxillofacial surgeon manages jaw and dental injuries.
• Neurologist monitors and manages neurological aspects.
• Nurses provide direct patient care and administer medications.
• Therapists work on physical and functional recovery.
• Dietitian ensures proper nutrition and weight management.
• Social worker offers emotional support and connects with community resources.
• Case manager coordinates and streamlines care.
• Psychologist or psychiatrist addresses emotional well-being.
• Primary care physician manages long-term care coordination.
• Radiologist provides diagnostic imaging.
• Pharmacist manages medication regimens.

By combining their expertise and working collaboratively, the team aims to provide comprehensive and individualized care to optimize Mary Nelson’s recovery and overall well-being.