St.
Anthony’s College
San Jose, Antique
NCM 100
Theoretical Foundation in Nursing
Submitted by:
HARO SETH N.
BSN 1-C
Nursing Department
St. Anthony’s College
San Jose de Buenavista Antique
Ms. Rachel Marie S. Yasay MN, RN
Course Instructor
SITUATION:
Mr. Juan Duran is a 60-year-old patient who has been coming to the diabetes clinic at the VA for
a few months. One day, the clinic director, Jim Carlson, finds him wandering the hallway,
appearing somewhat dazed, with a bag of supplies for blood glucose testing and insulin
administration. Mr. Duran tells him that he has been instructed to start insulin for his diabetes
but doesn’t know how. He doesn’t recall receiving any appointment or instructions. Mr. Carlson
finds the diabetes nurse educator, Jenny O’Connell, and asks her to fit Mr. Duran in for an
unscheduled appointment.
Jenny O’Connell starts the appointment with a thorough assessment of Mr. Duran. In addition to
the physical assessment, she covers psycho-social-spiritual issues. She discovers that Mr.
Duran has had diabetes for about 10 years, and, recently, his blood glucose levels and HgbA1c
cannot be controlled with oral medications and exercise. The physician wants to start him on
insulin. Here are notes that she took from her assessment:
ASSESSMENT:
Sixty-year-old Mexican American patient. He is exceedingly polite and respectful of health
care
personnel (and does not like to interrupt or ask too many questions). He has been in the United
States
more than 50 years; he is a Navy veteran.
Married; lives with wife in a comfortable apartment in Chula Vista, California.
Mr. Duran speaks fluent English, but his wife’s English is limited. They speak Spanish at
home.
Because Mr. Duran has limited vision, his wife has to administer the insulin.
Had one (single) daughter, who was found murdered in the apartment parking lot less than 2
weeks ago, leaving Mr. and Mrs. Duran to care for her child.
Mr. Duran seems befuddled by the insulin and syringes and is stoic when he talks about the
loss
of his daughter.
QUESTIONS:
1. Select one of the nursing models/theories from this chapter that will help Jenny in assessing
Mr. Duran and planning for his care. Discuss why that particular model was selected.
- For me Watson’s Theory of Human Caring would be perfect for this situation. This theory
promotes caring for the whole person, not just their body but their emotional and spiritual life
also. The above fits very well into Mr. Duran's complicated situation. Watson's theory works
really well because it emphasizes building a caring relationship and looking into cultural and
emotional issues, such as grief, and the challenges when managing diabetes.
2. Based on the model selected, what additional information would Jenny want to collect/assess?
3. Based on the model selected, how would Jenny initiate a plan of care (education) for Mr.
Duran?
4. Do you think that Jenny would assess and plan differently for Mr. Duran’s care if she used a
different model (than the one your group selected) for Mr. Duran? Why or why not?
5. Read Issues regarding the Nursing Practices that we must be aware and act upon with.
Among the topics, choose one topic and copy. Write the date and Author of this issues
and give your reflection as a student nurse how would you answer this issue.
