Module 2. Discussion Board. Clinical Judgement
Read the following Case Study:
Leon Right is a growing premature infant admitted to the NICU whose 32-year-old mother, Cassie Right, is described by the nurses in the unit as “difficult.” The baby is nearing discharge, but Cassie is reported to be “resistant” to learning about how to feed and care for her infant. She has other children at home, but none of them was premature. The nurse preceptor (Mary) and the Valencia student nurse (T) being precepted for this AM shift identify a priority of care as: parental teaching about safe feeding of her premature baby.
Mary has worked in this unit for 10 years. She observes the entire caregiving situation and sees that Leon’s condition is stable. Mary meets Cassie and notices she is quiet and sullen. Rather than beginning by explaining how to feed the baby, Mary asks about Cassie’s other children and shares a little bit about the challenges of parenting her own children who are of similar ages as Cassie’s other children. Cassie smiles and agrees. As time passes, Cassie begins to talk about what a frightening experience having a premature baby has been. Mary acknowledges those feelings. Cassie smiles and begins to ask questions about how to care for Leon. Mary answers those questions in a way that is tailored to what the mother has revealed about her family. Cassie demonstrates feeding Leon in a developmentally appropriate way (side-lying position to prevent aspiration) based on Mary’s teaching. At the end of the shift, Mary believes Cassie has made significant progress toward competence in meeting her baby’s unique needs.
In discussion with T Mary asks T to consider the experience. T identifies that part of the prioritization of the care was Mary getting to know the mother and building a relationship by sharing a bit about herself as a parent helped to create emotional safety and trust so that Cassie could talk about her apprehension as a first-time mother of a premature baby and then focus on learning infant care.
Using the Tanner Model of clinical judgement reflect on the aspects of this case: How will the use of the Tanner model assist with your care of patients?
