Student Absenteeism Case Study Essay
Order ID# 45178248544XXTG457 Plagiarism Level: 0-0.5% Writer Classification: PhD competent Style: APA/MLA/Harvard/Chicago Delivery: Minimum 3 Hours Revision: Permitted Sources: 4-6 Course Level: Masters/University College Guarantee Status: 96-99%
Student Absenteeism Case Study Essay
Jana Parks is a community health nurse employed by the district health department. She is a school health nurse, providing services for six schools in a moderately sized community.
After receiving a referral from school officials related to a student’s absenteeism, Jana plans to assess the student and family. (See the photo novella in this chapter for photos that depict this case study.)
Jana knows that the school is located in the inner city where 75% of the children come from families with a median family income at or below the federal poverty level.
English is the second language for approximately 25% of the students, and 5% are not fluent in spoken or written English. Each year, more than 20% of the student body moves into or out of the school district.
She reviews the school records for the student, Maria Garcia, and learns that this is the first year of enrollment for the sixth grader and her second-grade brother, Miguel.
Maria’s family moved to the area 6 months ago from the Dominican Republic. School records note that the girl is adequately fluent in spoken English but that the parents do not speak English. The student’s father works part-time at a local furniture manufacturer.
There has been a noticeable decline in grades over the previous quarter, there have been no disciplinary actions, and teacher comments are positive regarding the student’s classroom performance.
The health record indicates that she is up to date with required immunizations; no chronic illnesses are noted on the school physical examination record. Jana notes that Maria’s brother does not have the same school absence pattern.
Jana contacts the family and identifies her role as the school health nurse. She explains the need for a meeting with the student and family to discuss concerns about Maria’s school attendance.
A time is scheduled when both parents and the student are available. She confirms the home address and directions.
Jana notes that the house is in need of paint and some windows have been replaced with cardboard; however, the yard is free of clutter and there are containers of blooming plants on the small porch.
Maria Garcia opens the door, and Jana enters a small, dimly lit room. As the student makes introductions, Mr. Garcia stands and greets Jana with a nod and handshake while Mrs. Garcia remains recumbent on the sofa but raises her hand in greeting.
Mrs. Garcia’s appearance surprises Jana, as she appears much older than Mr. Garcia. Her skin is pale, her eyes are sunken, and she appears frail, with a distended abdomen and generalized muscle wasting.
Jana is aware that the exchange of social conversation is important in establishing a relationship with Hispanic clients. She mentions the beautiful picture in the room and learns that a family member painted it as a wedding gift for the Garcias. Jana learns that the family has no other relatives in the community and moved to the city through the work of a refugee assistance organization.
In this interview, Jana plans to collect information related to individual, family, and/or community functioning.
Throughout the conversation, Jana has noted that both Maria and Mr. Garcia appear tense; Mrs. Garcia is quiet and rarely speaks or smiles. Maria has translated throughout the conversation, although Jana senses that the parents may have limited understanding of spoken English.
To lessen anxiety, Jana begins the interview by saying, “I am here because the school and I are concerned about Maria’s absences. I want to learn why Maria misses school and to see if there are ways that the school can help.”
Through the interview process, Jana learns that Maria likes school and has made friends there. She observes that Miguel stays close to Maria and frequently hides his face into her shoulder when Jana speaks to him.
She also notes that Mr. and Mrs. Garcia rarely look at each other, and Mr. Garcia chooses a seat on the opposite side of the room. The family rents the home, and the father has been able to supplement his part-time income by working as a day laborer for a lawn service.
The family was beginning to establish connections at a local church and with neighbors when Mrs. Garcia was diagnosed with an abdominal tumor that has required numerous operations over the past 3 months. She is still receiving home care visits for a surgical wound that has not healed.
Although Medicaid has covered most physician and hospital expenses, the family has experienced out-of-pocket expenses for noncovered medications. These problems have contributed to family financial stress.
Mr. Garcia has to drive his wife to medical appointments; as a result, he is in danger of losing his job. Maria also attends these appointments to serve as the interpreter, resulting in her frequent school absences.
In addition, Jana learns that Maria has assumed responsibility for the household cooking, cleaning, and laundry since her mother’s illness.
Mr. Garcia shops at a small neighborhood groceria. Jana determines that with food stamps the family has adequate resources to purchase food, although Maria admits that she is still learning to cook. The family eats the evening meal together, frequently rice and beans.
Maria and Miguel are eligible for subsidized breakfast and lunch at school. Maria believes that it is her responsibility to help Miguel complete his homework, get to bed on time, and attend school regularly.
Mr. Garcia disciplines both children. Jana asks questions regarding family health practices and learns that they see a provider at the health department only when ill or for school requirements and do not seek dental care. She observes a number of medication bottles on a table near the sofa.
Risk for excessive stress related to time-consuming activities, insufficient finances, and insufficient recreation (Mr. Garcia and Maria)
Risk for personal injury related to improperly stored medications (Miguel)
Ineffective health promotion related to language and cultural differences and lack of routine dental hygiene (Mr. and Mrs. Garcia, Maria, and Miguel)
Risk for poor parenting and family crisis related to change in Mrs. Garcia’s ability to function, financial burden of treatments for ill family member, and disruption of family routines, mother’s illness, and mother’s prolonged illness
Inadequate systematic programs for linking Hispanic families to community resources
A plan of care is developed to meet the needs of the individuals, family, and community. Planning involves mutual goal setting between the nurse and family; mutual setting of objectives to meet goals, prioritizing or setting short- and long-term goals with the family, contracting or establishing the division of labor between nurse and family that will meet the objectives, and evaluating the process and outcome.
Mr. Garcia will recognize appropriate roles and responsibilities for Maria. He will identify and use resources to allow her to resume suitable educational, social, and family duties.
Mr. Garcia will identify and use community resources to assist with transportation needs and medication costs.
Jana noted a long-term need to discuss dental care.
Mr. and Mrs. Garcia will improve their English comprehension and speaking skills.
Relieve Maria of interpreting at medical appointments by identifying alternative interpretive resources.
Store medications in a secure location.
The family will be able to find and use appropriate services for physical and social support.
The family will learn to appropriately express their feelings related to the mother’s illness, social isolation, role strain, and/or fear.
The community will establish programs to support immigrant family needs for transportation, interpretation, and enculturation to the American medical system.
Mr. Garcia will identify existing programs available to support Hispanic immigrants.
Jana recognizes that many interventions must be carried out at the individual, family, and community levels.
Education regarding safe medication storage.
Referral to the Refugee Assistance Society or local churches for interpretive assistance.
Direct nursing interventions aimed at family functioning include the following levels:
Cognitive: New information is provided to the family that promotes problem solving. An example is referring the Garcias to the community free clinic for medical and dental care.
Affective: Families are encouraged to express their feelings, which may be blocking their efforts at problem solving. An example would be Jana’s planned validation of Mr. Garcia’s concerns regarding finances and the threat of losing employment.
Behavioral: Tasks are negotiated to be carried out either during the family interview or as homework between visits. An example is Mr. Garcia’s planned call to the Refugee Assistance Society.
Jana recognizes that her referral of Mr. Garcia to the Refugee Assistance Society to obtain support through existing programs is also an intervention at the community level. She engages in ongoing parafamily work to identify how the community can be mobilized to provide physical, mental, and social support to immigrant families. Does anyone at the community free clinic speak Spanish? Are interpreters available at health care facilities? Where do most immigrant families receive health care and social support? Are classes on English as a second language free of charge for Hispanic families? Are job skill training programs available for Mr. Garcia? Questions such as these bring up many areas of assessment that Jana will need to make with the Garcia family and the community in the future.
Jana helps the Garcias obtain a small lockable box in which to store medications. Mr. Garcia establishes contact with a local church, which provides a volunteer interpreter and driver for medical visits and twice-weekly delivery of meals. Mr. Garcia takes Maria and Miguel to the free clinic, where dental sealants are applied to their molars.
The social worker at the community’s free clinic meets with Mr. Garcia to offer him assistance in obtaining low-cost medications. Through this conversation, Jana identifies his reluctance to ask for financial assistance.
He states that he should provide for his family and that Maria should not have to assume the role of mother for Miguel. However, he does not see any other options at this time. She identifies that Mr. Garcia may be in need of ongoing support and suggests that he talk with a counselor about his concerns.
Mr. Garcia refuses to see a counselor but agrees that he will talk to the pastor of his church. Maria and Miguel meet with the school counselor as needed to discuss feelings related to their mother’s illness and the resulting family strain.
Jana identified that many community resources are available to immigrant families; however, information about them is limited and not readily accessible. She contacts the director of the Refugee Assistance Society, and together they initiate a community coalition to address this issue.
Levels of Prevention
Society’s expectations of the family are in transition. Application of the levels of prevention to families by the community nurse must take into account the changing family configuration; the financial, emotional, and physical burdens often compounded in the single-parent family; and the lack of resources, such as nonexistent or inadequate health insurance.
This chapter has established the importance of the family to individuals and society. Primary prevention with families becomes an essential element of any comprehensive family health plan.
From the family perspective, health education must address actual and potential challenges to health, such as immunizations of all family members, educating about resources to support the family financially and emotionally, encouraging exercise and activity, and empowering the family to build on strengths.
An example is using the family genogram to teach the family about predisposition to diseases and helping the family develop a health prevention plan.
The focus of secondary prevention for the family includes ensuring that the family has continued access to health care and resources for individual and family health problems. The changing economy in the United States has “closed the door” to regular health providers for some families.
The challenge to the nurse is helping the family locate and access continued care and teaching the family to move through the system of government assistance, which may be new and unacceptable for the family. The nurse must be politically active in lobbying legislators for continued resources to support families.
Tertiary prevention for family includes assuring that the needed resources are available to support long-term care of each family member.
An example of a community-based organization established and funded solely by volunteers is the Kelly Autism Program (KAP). KAP is “designed to provide services to adolescents and young adults diagnosed along the Autism Spectrum Continuum, as well as their families, while serving as a training opportunity for future professionals in a variety of disciplines.
KAP has programs for middle school, high school and post-secondary participants including higher education, vocational training, and job support” (Western Kentucky University, 2016, p. 1). It includes a comprehensive screening program and one-on-one support for young adults with autism capable of living and studying on a university campus.
Identify family types or situations (e.g., families of different cultures, gay or lesbian families, or never-married-mother families) that elicit “discomfort” in working situations. Identify ways to overcome barriers in working with these types of families.
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.
Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.
Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
The background and/or significance are missing. No search history information is provided.
Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.
There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
You Can Also Place the Order at www.perfectacademic.com/orders/ordernow or www.crucialessay.com/orders/ordernow