NR 443 Week 3 Graded Discussion Topic: Caring for Vulnerable Populations
Week 3 Case Study for Discussion
This case study provides you with an
... [Show More] opportunity to immerse yourself in the role of a community health nurse and explore the resources in your community. As you work through the case, reflect on what you have learned about community health nursing in this course, and how you can apply it to this case.
Your role: You are working as a community health nurse in your local health department. One of your roles with the health department is to case manage pregnant women who receive Medicaid. You work with an interdisciplinary team both within and outside the agency.
Team members:
• Anne is a fellow nurse with the health department. She is going on medical leave, so has asked you to assume this case.
• Christina is a social worker with the health department.
• Tracey is a case worker from Child Protection Services.
• Mark is a dietician with the local Women, Infants, and Children (WIC) office.
Your client: Mary is a 23-year-old Hispanic female. She is in her first trimester of pregnancy and is developmentally delayed. She also has been diagnosed with bipolar disorder. She is currently unemployed but receives Social Security disability checks monthly. She lives with a roommate in a project apartment complex in a run-down part of town.
Anne has visited Mary once and provided the following information as she hands the case to you. Mary had a baby removed from her care when she was 19 years old. Mary cannot explain why this baby was removed other than her house was dirty. She met the father of her current baby on the Internet and states that she has not heard from him recently.
During Anne’s visit, Mary stated that she wanted to keep the baby. She asked many questions about healthy eating and having a healthy pregnancy. Mary stated that she has visited the WIC office, received WIC vouchers, and met with Mark who talked to her about what to eat. She asked for help to find a nice apartment and to make other improvements so that she can keep this baby.
When Anne started to explore options and difficulties she might encounter in raising this child, she stated that Mary became agitated and did not comprehend why her baby might be removed from her other than “They are against me!”
Christina, Mary’s social worker, was able to find the past court records indicating that her first baby was removed due to neglect and living in an unsuitable environment. At that time, Mary was living with her parents in another county. The records indicated that Mary did not show up to her court appointment to appeal the decision, so the baby was permanently removed and has since been adopted.
According to Mary’s chart, Tracey from Child Protection Services has stated that CPS is planning on placing Mary’s baby into foster care when it is born due to her cognitive impairment and past history.
Your charge: As your first assignment, you are to identify resources in your community that could assist Mary during her pregnancy and help to optimize the health of her infant.
Assurance is one of the three core functions of public health. Read this week’s online lesson for more information on assurance. Find a resource in your community (other than WIC) that could assist Mary during her pregnancy. Start by searching the Internet for your local health department’s website. What services (other than your visits and the social worker) do they provide for pregnant women? What about your local welfare office? Are there prenatal or mental health services available? Are there any service organizations, crisis pregnancy centers, or churches providing help for pregnant women? Are there any organizations that serve the Hispanic community?
Briefly describe the types of services that you found and then choose one agency and assess this agency in terms of the 4 A’s. Is it accessible, acceptable, affordable, or available for Mary or other pregnant women that you case-manage?
This case study focuses on a vulnerable young woman who is facing many risk factors.
• Risk factors that may influence health outcomes for vulnerable populations:
o Mary is mentally disabled and very vulnerable. She is in jeopardy of losing her second child to the system if resources are not in place to allow for a stable upbringing for this child.
Risk factors:
Home: Where will she live this time? She was living at home with her parents the last time she gave birth and this still was not enough to be stable.
Income: What is her source of income? Is she able to work?
Mental Disability: Individuals with Mental Disabilities are often not stable enough to care for themselves let alone others. What is her level of disability?
Single parent: Who is her support system? Who is her daycare if employed?
Newborn: Having a newborn can be hard. Is she capable of taking care of a newborn?
Food: This goes back to income. If there is lack of income, is she enrolled in other food assistant programs to fill in the gaps in the kitchen? Is she capable of cooking safely?
• Services:
o SNAP (formerly Food Stamps) provides low-income households and the disabled with benefits to purchase food in order to maintain good health.
o The Medicaid Program in Erie County provides access to a variety of public health insurance programs including Medicaid, Family Planning Benefits Program and the Medicare Savings Program.
o Financial eligibility is determined based on the income and resource standards governing the Public Health Insurance Programs.
o Persons eligible for Medicaid may be required to enroll in a Managed Care plan.
Location:
Erie County Work Center
158 Pearl Street
Buffalo, New York 14202
Hours of Operation: 8:00 A.M. - 4:00 P.M.
Residents are directed to call 858-7239
o Medicaid:
Erie County Work Center
158 Pearl Street
Buffalo, New York 14202
Hours of Operation: 8:00 A.M. - 4:00 P.M.
o WNY Women's Foundation, Inc.•
742 Delaware Avenue•
Buffalo, NY 14209•
716-887-2621 or call WNY 2-1-1: call 211
• Mental Health, Emergency Shelter, Sexual Assault:
o Crisis Services 24 Hour Hotline: 716-834-3131
• Career Support Services:
o Dress for Success Buffalo: 716-842-0602 (drop-off hours: Wednesdays 10:30 a.m. to 2:30 p.m.)
• Child Care Resource Network: 716-877-6666
Health Services:
• NYS Health Care Marketplace: 1-855-355- 5777
• Planned Parenthood of Central & Western NY: 1-866 Health Services:
• NYS Health Care Marketplace: 1-855-355- 5777
• Leadership & Empowerment:
o Community Food System Program
o Hispanic Women's League, Inc.
o United Way of Buffalo & Erie County
o YWCA of WNY
• For Women:
o Church Women United
o Crisis Services
o Equality Now
o Free Adult Literacy Services
o Homeless and Hurting of Western New York
o Housing and Support Services
o National Partnership for Women and Families
o Schlorship Guide for Women
o WNY Women‘s Fund
o WNY Women's Foundation
o Violence Against Women
• Health & Wellness:
o Buffalo Prenatal-Perinatal Network
o Catholic Charities
o Developmental Disabilities Services for Children and Adults
o New York State Department of Health
o Planned Parenthood of Buffalo & Erie County
o Resource for Researching Women‘s Health
o The Health Care Association of New York
o I have chosen: WNY Women's Foundation, Inc
Accessible
716-887-2621 or call WNY 2-1-1: call 211
Web: https://wnywomensfoundation.org
Address:
742 Delaware Avenue•
Buffalo, NY 14209•
Acceptable:
Too all women
Affordable
Free
Available
Always available - The Foundation’s largest investment is in this research-based program designed to enable single mothers to gain family-sustaining jobs.
• Are there adequate resources for other vulnerable populations in your community?
o I think there are plenty of resource in the community if you know where to look. I think that due to Mary’s disabilities it may be complicated and will require assistance. However, if she were to get in touch with this organization she could be well on her way to freedom and the ability to raise her child.
Assurance means:
Enforce laws and regulations that protect environmental health and ensure safety
- In this case making sure that Mary and her child are save and cared for with the proper resources to sustain this living situation.
Link people to needed environmental health services and assure the provision of environmental health services when otherwise unavailable
- This agency could held link Mary with the resources she needs. These resources could help keep her sustainable.
Assure a competent environmental health workforce
- The agency as the means to help her find employment and/or schooling depending on her level of disability.
WNY Women's Foundation, Inc. (2018, January) https://wnywomensfoundation.org/
Erie County. (2018, January). http://www2.erie.gov/
Nies, M.A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier. [Show Less]