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Robert Anderson is a 57 year old male admitted to the ICU floor with stage 3 hepatic encephalopathy. His condition was caused by liver cirrhosis that was a result of chronic hepatitis C from a blood transfusion in the 1980s. This is Robert’s second admission in 3 weeks, as he was sent home with a home care regimen to mitigate stage 2 hepatic encephalopathy; his home care regimen included assignment of a case manager, a referral for home health nursing, and physician follow ups to assist in his management of this condition at home. The first implementation of case management for the Anderson family was not implemented until after his stage 2 hepatic encephalopathy admission and discharge. Shortly after readmission, Robert fell into a coma and his physician began to discuss the option of hospice care with the family, which was declined. Unfortunately, due to the advanced condition of his disease process, Robert continued to deteriorate after his readmission and passed away during this hospitalization.
Discussion Questions
- What do you believe the nurse’s role is in regard to family support for families with rapidly declining loved ones?
- Do you believe that earlier implementation of case management would have had a more positive outcome on this patient scenario? Why or why not?
- What are additional resources that the nurse or case manager could have implemented in an effort to improve the outcome of this patient?
