Week 7: Deborah Henderson

Winter 2022
1G03
Lindsay Kipp, RN, MScN
 • Icebreaker & Housekeeping
• Deborah Henderson
narrative
Agenda • Data collection
• Concept mapping
• Break
• Hypothesis generation &
learning gaps
• (Discussion re: MS based
on readings)
• Plan for next week
 Icebreaker & Housekeeping

9/3/20XX Presentation Title 3

 Through Deborah’s Eyes:
Deborah Henderson

9/3/20XX Presentation Title 4

PBL-PBL
Process
 Another way to view the steps of the PBL
process:
1. The problem is presented to the group, terms are reviewed, and
hypotheses generated
2. Learning issues and information sources are identified by group members
3. Information gathering and independent study occurs
4. The knowledge acquired during independent study is discussed and
debated critically
5. Knowledge is applied to the problem in a practical way and the initial
hypotheses are confirmed or refuted
6. Reflection on the content and process of learning occurs
(Rideout & Carpio, 2001, p. 29, as cited in BScN Handbook, 2020)
Narrative  aesthetic knowing
Interview
 Deborah Henderson
Background information leading up to this point…
• Julie is a 45 year old female with Multiple Sclerosis. Julie was diagnosed at
age 32 after finishing University and starting her career path. Her partner
Deborah is 55 years old and has been her constant care provider since she
became confined to a wheelchair 1 year ago. Deborah has taken a leave from
her high paying marketing job in the last month to be home with Julie to attend
to her daily care needs. As the Home Care Case Manager you go to visit Julie
at the request of the family physician. When you are done, you ask her if there
is anything else you can do for her before you leave. Julie becomes teary and
says, “not for me….but I really think that Deborah needs some help.”

9/3/20XX 8
The narrative
• Let’s watch x1– goal is to just watch. What are your reactions
• Then we will watch again. Goal is to observe the art and
consider aesthetic knowing.
Aesthetic knowing
• “Aesthetic knowing in nursing involves deep appreciation of the
meaning of a situation and calls forth inner creative resources that
transform experience into what is not yet real, bringing to being
something that would not otherwise be possible. . . Aesthetic knowing in
practice is expressed through actions, bearing, conduct, attitudes,
narrative, and interactions of the nurse in relation to others.
• It also is formally expressed in art forms such as poetry, drawings,
stories, and music that reflect and communicate symbolic
meanings embedded in nursing practice.” (p.7-8)
Looking at art
1. What is the first thing you see?
2. Note where your eye goes as you look at the work of art, this is
how the artist has arranged the elements of art to get you to move
around the painting.
3. Look again and observe the elements of art.
4. Look again and ask yourself, “what does this mean to me?”
Elements of art: the tangible things an artist
creates with (the ingredients of art)
• Value: the lightness or darkness of the image.
• Colour: hue (name of the colour), value
(lightness or darkness), intensity (brightness or
greyness), and temperature (warm or cool).
• Texture: how the surface looks or feels.
• Shape/Form: the outline of the image or
object.
• Line: a mark with length and direction (more
length than width). A continuous mark made on
a surface with a moving point.
• Space: the area around, within, or between
objects.
Principles of art: the way the elements are used
to create artwork (the recipe for what you are
creating)
• Balance: how the artist creates stability in the
artwork.
• Emphasis: importance given to one part in the
art work (usually where your eye immediately
goes).
• Movement/Rhythm: how the artist uses
elements to direct the eye around the art work.
• Contrast: using two elements of art together
which are different from each other.
• Pattern/Repetition: repeated use of similar
elements (such as colour or line).
After the narrative:
• What are your initial reactions? Thoughts? Feelings?
• Who is the “person” in this scenario?
• What are the strengths? What are the challenges?

• What do you know? What would you like to ask Deborah about? What
are priority areas for assessment (consider Gordon’s functional health
patterns)?
Concept mapping
• In your small group generate a concept map related to Deborah
• Consider what you know about Deborah and her situation and
what you might need to learn
• Let’s be systematic and organized. Work from large concepts
to more detail. Be holistic in your considerations
• Let’s use old fashioned chart paper and markers!
Break
Hypothesis Generation
Continue in your small groups.
Based on the information you organized in the concept map, what are your hypotheses about this
situation?
1. Deborah is experiencing burn out (objective/subjective caregiver burden, care giver burnout,
caregiver fatigue)related to caring for Julie AEB refusing help from others, feeling exhausted
2. Deborah is struggling to care for self related to caring for Julie AEB her feelings of exhaustion, lack
of self-care
3. Deborah is worried about financial income related to caring for Julie/absence from work AEB her
statements
4. Knowledge deficit r/t MS supports/community resources AEB lack of current supports for the family.
Respite, chronic illness
Learning needs  Prioritization
Based on what you know about this situation, your current
knowledge base, and what your hypotheses are, develop
learning questions
1. Deborah is experiencing burn out (objective/subjective
caregiver burden, care giver burnout, caregiver
fatigue)related to caring for Julie AEB refusing help from
others, feeling exhausted
2. Deborah is struggling to care for self related to caring for
Julie AEB her feelings of exhaustion, lack of self-care
3. Deborah is worried about financial income related to caring
for Julie/absence from work AEB her statements
4. Knowledge deficit r/t MS supports/community resources
AEB lack of current supports for the family.
Respite, chronic illness
1. What is Avonex? (Julie’s medication)
2. E- What does care giver burnout look like?
3. E- How can care giver burnout be prevented? What are
self-care strategies for a caregiver?
4. SPLIT in small groups- What are some MS supports
available to Deborah and Julie? (Financial supports,
emotional supports, social supports, physical care
supports, community resources)
5. E- What is MS? What is nursing care for patients with
MS?
6. E -What is “Home and Community Care Support
Services” (formerly LHIN, CCAC)?
7. SPLIT What is respite and how can it help caregivers?
8. SPLIT What is the difference between caring for
someone with chronic illness vs acute illness?
Some intro resources
• MS Society of Canada
• Impact & Diagnosis of MS
• https://www.youtube.com/watch?v=M7O78LvrNSQ
• Pathophysiology
• https://www.youtube.com/watch?v=Naecv3h868c
• Caregiver Role
• https://www.youtube.com/watch?v=LPSy6WBGtsA
• https://www.youtube.com/watch?v=zlnB0bDs17E
Discussion: MS
• What is MS?
• What is the cause?
• How is it diagnosed?
• How does the disease progress? How do symptoms present?
• What are the types of MS? How do they differ?
• What treatment is available?
Class Eval
• A positive risk I noticed someone took today was…
• Next week I will challenge myself to…
Wood’s
learning
curve in
PBL
Next week-
see learning sequence and manual
• Teaching Plan- Due Mon March 7- all groups
• Discuss new learning questions/gaps identified this week
• Concept class: Understanding family as client
• Plan for SP week 9