CASE STUDY You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed. 1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient. 2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work. 3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being. 4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.


In this case study, we will be discussing the care of an 82-year-old woman who has been hospitalized for burns sustained during a cooking accident. The patient reported having no surviving family, and her support system consists of elderly neighbors who are unable to visit frequently due to transportation difficulties. Furthermore, the patient is deeply attached to her Yorkshire terrier, which is currently being cared for by one of her neighbors. The patient is requesting to see her dog, and the nursing staff has expressed concerns about her well-being. In this analysis, we will apply the theoretical framework of Florence Nightingale to address various aspects of the patient’s care.

1. Interventions Based on Nightingale’s Work:
Florence Nightingale, often considered the founder of modern nursing, emphasized the importance of a clean and healing environment, as well as psychological and social support for patients. Based on her principles, specific interventions for this patient can be identified:

a) Environmental Consideration: Ensure the patient’s room is clean, well-ventilated, and adequately lit to promote healing and overall well-being. Pay attention to noise reduction and create a calm and comforting atmosphere.

b) Infection Control: Teach the patient about the importance of hand hygiene and proper wound care to prevent infection. Utilize appropriate precautions to minimize the risk of hospital-acquired infections.

c) Social Support: Engage the patient in activities that promote social interaction, such as group therapy or organized recreational activities. Encourage her neighbors to visit and provide emotional support. Facilitate communication between the patient and her community through phone calls or video chats.

d) Emotional Support: Assess the patient’s emotional state regularly and provide counseling or therapy if needed. Foster a therapeutic nurse-patient relationship to establish trust and provide emotional comfort.

2. Action Regarding the Patient’s Request:
Considering Nightingale’s principles, it is important to recognize the patient’s emotional attachment to her dog, as it can significantly impact her well-being. Allowing her friend to bring the dog to the hospital would demonstrate empathy and support for the patient’s emotional needs. However, various factors need to be considered before taking action.

a) Infection Control: Assess the hospital’s infection control policies regarding animals in healthcare settings. If there is a risk of infection, alternatives such as arranging supervised visits in an outdoor area or arranging for a therapy animal to visit the patient can be explored.

b) Psychological Impact: Evaluate the potential benefits of the patient seeing her dog versus the stress it may cause the dog and potential disruption to the hospital environment. Discuss the request with the interdisciplinary team and consider their input.

c) Patient’s Well-being: Assess the patient’s overall condition and emotional state. If the request is deemed reasonable and does not compromise her health, allowing the dog to visit may provide comfort and emotional support.

The decision regarding the patient’s request should be made in collaboration with the patient, her healthcare team, and the hospital’s policies, ensuring the balance between emotional support and infection control measures.

3. Nursing Diagnoses and Interventions:
In addressing the patient’s nutritional status and emotional well-being, the following nursing diagnoses and interventions based on Nightingale’s work can be considered:

a) Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to poor intake and depression.
– Interventions: Collaborate with the healthcare team to assess the patient’s nutritional needs and develop a tailored plan. Offer small and frequent meals, incorporating her food preferences. Involve a dietitian to provide dietary counseling and monitor her nutritional status regularly.

b) Nursing Diagnosis: Risk for Impaired Social Interaction related to limited support system and isolation.
– Interventions: Facilitate social interaction by connecting the patient with support groups, community resources, or religious organizations. Encourage her to participate in therapeutic activities or hobbies of interest. Provide emotional support and ensure she feels valued and heard.

As the primary nurse, it is crucial to monitor the patient’s progress towards meeting the desired outcomes related to her nutrition and emotional well-being, reassess the nursing diagnoses, and modify the interventions as necessary.

4. Planning for Discharge and Role of the Discharge Team:
The planning for the patient’s discharge should commence early in her hospitalization to ensure a smooth transition. The discharge team may consist of healthcare professionals such as nurses, physicians, case managers, social workers, and any necessary specialists.

a) Nurses: Coordinate the patient’s care and ensure that all nursing interventions and assessments are documented accurately. Collaborate with the interdisciplinary team to address the patient’s needs and preferences.

b) Physicians: Assess the patient’s medical condition, prescribe necessary medications, and review the treatment plan. Communicate with the nursing staff to ensure a comprehensive discharge plan.

c) Case Managers and Social Workers: Evaluate the patient’s social support system and facilitate appropriate referrals, such as home care services or rehabilitation programs. Address any financial or insurance concerns related to the patient’s discharge.

By advocating for the patient and ensuring continuity of care, the nurse can contribute to a successful discharge process. Nightingale emphasized the importance of providing patients with support and education to promote their well-being during the transition from hospital to home care. By implementing her principles, the nurse can advocate for the patient’s needs and ensure a safe and supportive discharge plan.

In caring for the 82-year-old patient, using Nightingale’s theoretical framework, we have addressed specific interventions, evaluated the patient’s request to see her dog, identified nursing diagnoses, and discussed the planning for discharge. By applying Nightingale’s principles, the nurse can provide holistic care, promoting healing, and ensuring the patient’s overall well-being.