Case: Jenny Brown (Iraq veteran)
Overview: Jenny Brown is a 23-year old female who served in a combat zone in Iraq. She lives with her boyfriend in an apartment in a small urban community. Jenny is a college student, studying construction management at a local university. She is 18 weeks pregnant and lives with the baby's father, Eric, a 25-year old welder. This is Jenny's first pregnancy. Other than some bothersome nausea that ended about 6 weeks ago, the pregnancy has been uneventful to this point.
Monologue:Jenny is a patient in a short'stay, emergency psychiatric facility. She voluntarily agreed to admission yesterday following an acute episode of agitation and anxiety that occurred after she was told that her ultrasound revealed that her fetus has a cleft lip and palate. When the nurse comes to Jenny's room, Jenny provides important details about her life and reveals some of her experiences in Iraq that suggest she may have Posttraumatic Stress Disorder (PTSD). The nurse calls Jenny's boyfriend Eric and learns more about Jenny and her mental health since her return from Iraq.
Jenny and Eric's Introductory Monologue
Simulation Scenario 1 occurs in an adult short stay mental health care unit located in an acute care hospital. This scenario focuses on the use of assessment tools to screen for anxiety and depression, suicide, PTSD and traumatic brain injury.
Simulation Scenario 2 takes place several weeks later. Jenny is now 30 weeks pregnant. The nurse is making a home visit to discuss preparations for the baby, including specialty care arrangements for health issues related to the infant's cleft lip and palate. During this visit, the nurse performs and antenatal assessment and provides anticipatory guidance about the remainder of pregnancy, childbirth preparation, labor and birth, and care of the infant immediately following birth. She also initiates discussion around the likely course of care for infant with a cleft lip and palate.
Simulation Scenario 3 occurs in a hospital obstetrical department where Jenny is a patient following the birth of her daughter, Samantha. The focus is on the role of the nurse in performing both newborn and postpartum assessments, including administration of a postpartum depression scale, providing postpartum education, and anticipatory guidance to the parent of an infant with a cleft lip and palate requiring surgical repair.
Finish the Story Assignment
Learners have now seen Jenny at three snapshots in time. What do they think his life will be like three months from now?
Author Cynthia Fitzgerald, PhD, RN
Assistant Professor - Washington State University