In: Nursing
CASE #3
You have been assigned to care for the Ross family. The family just had triplets: three girls. The girls were premature, but they are now home after two months in hospital. There are two older children in the family, Ray, age two, and Lori, age five. Although maternal and paternal grandparents are all living, they reside 1600 km away and cannot visit to help.
The family seems to be loving and close-knit. The parents seem very happy with the new additions- although they admit that the birth of three was very much a surprise.
You have been with the family for two months and over that time have noticed a change in Ray. He seems less able to run as steadily as he did before. As well, he seems to be using more "baby-talk," not speaking words as clearly as he once did. He also seems to be more fearful.
Today is your day off. You find yourself in the Ross neighborhood and decide to say hello. As you go up to the door, you see Mrs. Ross violently shaking her son. She is visibly upset and is speaking to him in a very angry voice.
1. Describe all the feelings that you (or other PSWs) might have in this situation. Explain how they might be helpful or unhelpful in resolving the problem. (2 marks)
2. Identify the possible reasons for the angry outburst in Mrs. Ross.
3. Identify two behaviors in Ray that indicate that he may be abused.
4. What action is appropriate for the PSW to take in this situation? Why?
1. The feelings about the situation are Ray is showing an attention seeking behaviour as the parents are taking more care on newborns. Ray also would have felt sibling rivalry as the newborns are seen pampered.
Mrs. Ross could have the feelings of helplessness, as the support systems are less, to adapt her to the situation which is more responsible. She would have failed to complete her responsibilities as a mother of a preschooler, toddler and three newborns. As the newborns are premature, she will be attending them more than the other children. She would be also upset by seeing the changes in the behaviour of Ray. The assessment of the present situation will help to resolve the problems by giving proper counselling to Ray and Mr and Mrs. Ross.
2. The reason for anger outburst are probably
. Feeling of frustration with more responsibilities
. Helplessness
. Lack of support to take up additional responsibilities
. Guilty feeling of not fulfilling the responsibility towards older children
. Lack of knowledge and experience to handle the situation.
. Upset of change in behavior of Ray.
3. . Ray is not able to run steadily as before.
. Ray is more fearful, which shows psychological abuse
4. PSW can take the action such as
. Counsel the parents about the situation and the changes happened in Ray. As the family lived happily before, this was a temporary problem, which can be resolved.
. Give an individual therapy or play therapy to Ray to make him to understand the changes in the family.