Case Study

Case Study

Russell was a 16-year-old boy, was brought in to the homeless organization where I assessed and examined him in my role as a student ECP. There were aspects of the consultation that I felt were good and bad but on reflection it was more successful than I anticipated it to be. Russell and his mother thanked me and left the department to go home.

I realised that it was not just Russell I had to deal with but his mother as well (Pantell et al 1992), particularly as she was going to be present throughout. It was just as important to keep mum relaxed so she would not convey any negative anxious feelings to her son. This however, did not appear to be a major problem as mum and her son appeared to have a good rapport. I also understood the importance of addressing Russell and not focus my attention to his parent (Pantell et al 1992), it was important for him to tell me the story of what had happened.

I completed my initial assessment of Russell, which had consisted of his presenting condition, his history of his presenting condition, past medical history. I then attempted, with a degree of success, to put in plain words what I was going to do and that afterwards I would have to have a good look at his wound.

My overall impression of Russell was that he was a well-behaved sensible child, that he might not get too upset at my attempts to review his wound. I asked Russell to look up and count the flies on the ceiling, hoping this distraction (ref) would be long enough for me to inspect the wound and assess how deep it was and whether I could see the base of the laceration. The wound appeared to be approximately 2 cm long and I could easily see the base of it, and it had not bleed now for about half an hour. Looking puzzled, Russell then exclaimed there were no flies in the room. Fortunately, my distraction had worked. I was now able to leave Russell with his mother whilst I documented my clerking notes to enable me to present the case to the HOMELESS ORGANIZATION Advice worker.

This was the first day of my second set of placements, and although the A&E staff knew the objectives of my purpose in the department, I had met with some resistance from the Advice worker who opposed the idea of ECP's and they had been reluctant to monitor/mentor me. Hawkins and Shohet (1989) identified this behaviour as destructive and that we should learn to manage these individuals and attempt to understand how they operate. Holloway and Whyte (1994) agreed with this concept, and the apparent behaviours were not the qualities expected from enablers (mentors). However, the advice workers in contrast were very supportive and interested that I should gain as much valuable experience as I could.

We can apply Erikson's psychosocial theory to the case of ...