FINAL CASE PRESENTATION

BSN LEVEL III STUDENTS

GENERAL OBJECTIVES

Case presentation seeks to demonstrate the student’s knowledge regarding the general health and disease condition of a patient with diagnosis, its disease process, possible complications, treatment plan, medical and nursing interventions.

SPECIFIC OBJECTIVES

Accurately present a thorough general assessment of the client which includes physical assessment and family history taking.

Understand the pathophysiology and etiology of the case being presented. Understand the role of drug therapy in managing the client related to the patient’s

diagnosis. Recognize the contributing factors associated in the development of the diagnosis. Systematically present the data pertinent to the case being gathered. Efficiently provide appropriate and proper nursing diagnosis in line with the client’s

medical condition and skillfully formulate nursing care plans for the problems identified. Appropriately apply nursing interventions necessary for the patient’s condition in

reference with the learned theories and concepts of the disease. Exhibit mastery and tact in answering relevant questions with positive attitude towards

criticisms and suggestions.

INTRODUCTION

"Tell me and I'll forget; show me and I may remember; involve me and I'll understand." - Chinese Proverb -

If you are just hearing information, like a teacher lecturing, you will forget it. If somebody actually physically shows you themselves,

like a teacher demonstrating, you will remember. If you actually have to do it yourself, like a case studies, you will understand it.

The case study is a popular teaching strategy frequently used in academic settings. As an active learning strategy, the case study builds on learned material that encourages students to more fully understand the content being presented. The most common type of case study is problem based, which requires learners to develop solutions to a given scenario (Synder & Mc Willian, 2011). Similar to clinical practice, case studies are often designed to be complex and ambiguous, offering the learner an opportunity to build critical-thinking and problem-solving abilities (Plack & Santasier).

One purpose of the case study is to depict realistic situations that can facilitate discussion and promote the decision-making skills of the learner. Case studies are beneficial in the clinical setting to enhance the application of previous knowledge, attain practical knowledge, and improve problem-solving skills (Henning et al; Synder & Mc William, 2011).

In the field of nursing, one encounters a wide-array of various diseases and conditions. In order to give adequate and holistic care to individuals, it is necessary that nurses be equipped with the proper knowledge and skills for dealing with different health states. It is only through continuous learning that nurses acquire the necessary skill. A case study is a means of continuing such learning. In doing a case study, the students delve into the question, “what is this disease condition?” Student nurses learn actively and will be able to handle patients and experience what it means to care for a patient with that particular condition. The student nurses learn, from continuous interaction with the patients alongside with inquiries into books and informative journals of the disease process, it symptoms and corresponding treatments.

NARRATIVE REPORT

Friday 9th October 2015 at the College of Nursing Allied and Health - Amphitheater, the nursing students from level III was getting ready for their grand case presentation. Everybody helped in making all the preparations, so that when the panelist’s arrives everything was set and ready.

The Clinical Instructor Ma. Janice M. Bernardo R.N. M.S.N, who has been teaching for many years in Nursing Care Management 103 (Care of Client with Problems in Oxygenation, Fluid and electrolyte Balance, Metabolism & Endocrine) and served as the adviser of the nursing students from level III was one of the panelist; Along with the two guest panelist Ms. Mary Grace Sacro R.N. and Ms. Hannah Janina Dejesa R.N. who were the former student of LSPU-CONAH from batch 2014. Then, followed by the Clinical Instructor Granada Minerva R.N. M.A.N., who is also the lecturer of Nursing Care Management 103 (Care of Client with Problems in Oxygenation, Fluid and electrolyte Balance, Metabolism & Endocrine) and one of the Clinical Instructor in Related Learning Experience none other than Mrs. Myranie L. Sy R.N M.A.N.

Those 5 panelists are the one who witnessed, criticized, and questioned the presentation of the two groups with their each two cases. The Group 1 presented cases about Cerebrovascular Accident Infarct and Hyperthyroidism, while the Group 2 presented cases about Congestive Heart Failure, Cardiomyopathy, Coronary Artery Disease and Cholelithiasis.

Like every program, at exact 8 o’clock in the morning it started with a greeting from the master of ceremony which was Ms. Rozelle Mae Birador who acknowledged the presence of the panelist. After the greetings a prayer was led by Mr. Darren Jericho Tinea who asked for guidance, knowledge and strength from our Lord GOD. Then it was followed by a video presentation of the Philippine National Anthem which symbolizes the patriotism and fighting spirit of the Filipino people. A message was given by Ms. Daira Lee Ortiz, the class president of the BSN III-A who thanked and acknowledged the panelist which guided us throughout the whole semester and provided us the well-equipped knowledge. She also expressed her appreciation for the efforts and teamwork of the whole class that never gave up on each other and helped one another not just as fellow classmates or friends but as a family.

Everything and everyone was ready for the grand presentation but before it was started, each group prepared a simple intermission number to release all the tension and to give an entertainment to everyone. The group 2 performed a very amusing assessment of a patient in a form of musical play related to our course Nursing Care Management 103 (Care of Client with Problems in Oxygenation, Fluid and electrolyte Balance, Metabolism & Endocrine). The presenters showed their willingness to perform and they enjoyed their performance.

After an entertaining presentation, the group 1 started to present their case about Cerebrovascular Accident Infarct. The students chose this case study to widen their knowledge about neurological problem; also to enhance their critical thinking in analyzing the case and decision making skills on what proper nursing interventions that should be should implement. The members of the group started to discuss everything about the disease, identifying the patient’s data and history until it came up to the physical assessment of the patient.

Upon in defending the content of physical assessment, the students were questioned by the panelists on ‘why & how’ you came up on these kinds of findings to the patient. They were questioned that the patient with CVA is really in a stupor when you handle? Or just lethargy?

During that time, everyone was confused. The panelist decided to halt the presentation and revised the physical assessment not saying that the findings were wrong but making us to realize what must be improved and analyze thoroughly. In despite of this situation, the Group 1 accepted the comments of each panelist for they know it was for the best.

Then, after on what happened to the case of Group 1 it is the time for Group 2 to present their case study about Congestive Heart Failure, Cardiomyopathy, Coronary Artery Disease. Everything went smoothly for them; they presented their case with few corrections. The group was questioned by Clinical Instructor Granada Minerva R.N. M.A.N. “Is Cardiomyopathy developed first before it leads to Coronary Artery Disease? Or Is Coronary Artery Disease developed first before it leads to Cardiomyopathy?” The members of the group answered the question with their idea that the Coronary Artery Disease developed first to the patient before it leads to Cardiomyopathy.

At 12:15 pm everybody went for lunch, everyone had a good lunch together. At exact 1:00 o’clock pm the program resumed and the group 1 presented a case about Hyperthyroidism followed by group 2’s case presentation about Cholelithiasis, everything went good for them during that time and each group was happy that another semester has ended with great outcomes.

Before the program ended each panelist gave a message to the BSN III-A students, the first was Clinical Instructor Myranie L. Sy M.A.N, who told us that the most of the questions that they’ve been asked was very common to asked for during in the presentation of case study. She also added that they are there to help whenever we encounter problem in analyzing the case. Next was Ms. Mary Grace Sacro R.N. who shared her experienced as a nurse that it isn’t easy when it comes to the actual thing. She emphasized that once you become a registered nurse, there is no supervision of clinical instructor anymore and you have to rely on the knowledge that you’ve been acquired during your student days. She was also thankful that she got to be one of the panelist were she can refresh and still learn from case presentations that has been presented. Then, it was followed by Ms. Hanna Janina Dejesa R.N. who gave an advised that in presenting cases we should only put the necessary things that is needed like in laboratories we should only present the abnormal findings not the normal findings and when presenting a case if possible we should only put the title not the whole detail to keep it short but substantial. Lastly, Clinical Instructor Ma. Janice M. Bernardo R.N. M.S.N mentioned that although we’ve already finished

the Nursing Care Management 103 (Care of Client with Problems in Oxygenation, Fluid and electrolyte Balance, Metabolism & Endocrine), we should always keep the lectures in our minds and in our hearts because this will be useful in the near future. She kept on telling us we should not be satisfied with the little knowledge we acquired because every day is an opportunity to learn something new.

  Despite of the sleepless nights sacrificed to complete the case study, the efforts in the end have paid off. The program ended with happy faces and joy among our hearts that we are almost close to graduating and achieving our dreams in becoming successful nurses in the future. Even though the case had been done in such a busy and turbulent time, still the manuscript serves as proof that with the belief and faith in God and the unity of team work, all things are possible. PRAISE BE TO GOD!