Mary, the patient the study focuses on (surname withheld to uphold confidentiality), was chosen due to the writers involvement throughout the duration of her stay in hospital. The writer met Mary prior to her operation in theatre and was present for the duration of her operation. When Mary was admitted to ward L4 the writer was directly involved in Mary's care and discharge.
Mary is a 75 year old widowed lady. She is a devout Roman Catholic and attends church every Sunday. She is retired, during her working years used to work for a local catalogue company. She lives in a ground floor flat prior to admission she normally mobilised with a stick although she still enjoyed walking. She has one daughter who visits regularly on a weekly basis. She is a smoker and smokes twenty cigarettes per day for the past fifty years. Mary receives no home care input from social services and considered herself independent around the home prior to admission. She was admitted to hospital due to a fall at home, Mary had no previous history of falls. On investigation at hospital it was found that she had fractured her left Neck of Femur. Subsequently, this led to an operation in which a Thompson's Hemiarthroplasty was performed which involves a replacement of the Neck of Femur with a prosthesis. Following the surgery Mary's recovery was gradual, the members of the multi-disciplinary team, Mary and her family felt she would benefit from further rehabilitation consequently she was referred to ward L4. The ward is an orthopaedic rehabilitation unit which endeavours to promote a patients recovery, restore confidence and maximise their independence. The rehabilitation programme is achieved through a multi-disciplinary approach. The core members of this multi-disciplinary team undertake an assessment with each patient and then together they plan and implement an individual rehabilitation programme that will meet each patients individual health needs. When Mary was transferred to ward L4 she was introduced to her primary nurse and the members of the team to which she was allocated as the ward operates on a team nursing basis to deliver care. Consistency in staffing encourages a development of trust and the promotion of a ' surrogate family' (Holloway 1988).
In 1946, the Constitution of the World Health Organisation defined health as:
' Health is a state of complete physical, mental and social well-being, and not merely the absence of disease of infirmity' (WHO 1946)
This definition takes a holistic view of health which is to treat the patient as a whole including social and mental well-being, not just their symptoms. The initial assessment at the ward level allowed the identification of Mary's holistic health needs. Spiritual needs identified were her religious beliefs and practice as a Roman Catholic. The expression of her religious beliefs was respected and appreciated by all the staff. As previously acknowledged Mary regularly attends church. To ensure that this aspect of her life was maintained she was advised of the hospital church and encouraged to attend mass. She declined initially saying that she did not feel physically capable of attending. The Roman Catholic priest visit's the ward on a weekly basis every Friday, it was arranged that Mary would receive Holy Communion at her bed side. This was greatly appreciated by Mary as she felt she could still practice her religion. Sociocultural needs raised were: Mary's wound was found to be infected with Methicillin-resistant Staphylococcus aureus (MRSA). As per infection control policies in place in the trust Mary was transferred to a...