red toolkit monologue

Topics: Geriatrics, Nursing, Elderly care Pages: 5 (800 words) Published: June 22, 2015
Instructor’s Toolkit for Red Yoder’s Monologue
Red’s introductory monologue can be used in a variety of ways. Here are a few to consider: ƒ large class discussion
ƒ small group discussion during class or clinical
ƒ reflective journaling assignment
ƒ web-based assignment: listen to the audio or read the script, then discuss and summarize the group’s conclusions.
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2.
3.
4.
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6.

What are Red’s strengths?
What are your concerns for this patient?
What is the cause of your concern?
What information do you need?
What are you going to do about it?
What is Red experiencing?

These questions were adapted from the following publication: Benner, P., Sutphen, M., Leonard, V., Day, L., & Shulman, L. (2010). Paradigm case: Lisa Day, classroom and clinical instructor. In Educating nurses: A call for radical transformation (p. 133). San Francisco: JosseyBass. Possible answers to questions:

1. What are Red’s strengths?
ƒ Red has his son and daughter-in-law who live nearby and are active in his life. ƒ He has a close group of friends at the VFW and he has ties to his church. ƒ He is cognitively and physically active.

2. What are your concerns for this patient?
ƒ Red’s sore on his big toe is concerning, along with the fact that he has had this for three weeks without telling anyone.
ƒ Several times he speaks of items he eats or drinks that are a concern due to high calorie and fat content (cake, bacon, beer, donuts).
ƒ He also has a daily intake of alcohol and uses Benadryl to help sleep. ƒ Red made two statements about his son (“Jon got real mad,” “Jon gets so irritated”) that bear further assessment to rule out mistreatment. ƒ Does Red have adequate finances?

3. What is the cause of your concern?
ƒ Red is trying to manage his wound on his own without consulting his family or doctor.
ƒ He is experiencing sleep disturbance.
ƒ Family dynamics may be the source of anxiety for Red.
ƒ He also mentioned a concern about his VA benefits paying for the cost of the home care nurse.

4 & 5. Needed information and next steps:
ƒ How is Red managing his diabetes?
ƒ Need more information related to his diet, monitoring his blood glucose, and administration of insulin.
ƒ What is his financial situation? Can he cover the cost of his living and medical costs?
ƒ Red’s functional status should be addressed, especially his history of incontinence, falls, and difficulty sleeping.
ƒ Red is living at home and his son is helping out most of the time. Does he need legal advice regarding his farm?
6. What is Red experiencing?
ƒ He is experiencing skin breakdown in which the healing processes is complicated by his diabetes.
ƒ He wants to remain independent, living in his home and is concerned about taking care of his farm.
Other ideas:
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Have students listen to Red’s audio and respond to questions before coming to class. Create a Facebook page for Red (or have students do this) with pictures of his farm throughout the years, his grandson who is in college studying agriculture, and his friends from the VFW.

We encourage you to be creative and add to the monologue or create new monologues that match the content in your curriculum. You might consider expanding the case until you have monologues and simulation scenarios that can be used throughout the entire curriculum.

The ACES Essential Nursing Actions can serve as a guide to learners when deciding what interventions may be appropriate for the older adult in this situation.

ACES Framework
Essential Nursing Actions

Assess

ƒ

Function
and
Expectations

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Coordinate

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and
Manage
Care

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Use

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Evolving
Knowledge

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ƒ

ƒ
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Make

Situational
Decisions

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Assess the older adult’s individual aging pattern and functional status using standardized assessment tools.
Use effective communication techniques to recognize, respond to, and respect an older adult’s strengths, wishes, and expectations.
Include...
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