NUR100: Jamie Nursing Case study

Case Study

Introducing the Family

This is a nuclear family in Nambour, living in a mortgaged house, consisting of the following:

• Jamie (5 years) – Year one, Palmwoods Primary School, recently diagnosed with ASD.

• Anne (mother, 32) – Part-time accounts clerk, working 2 days a week. Married Peter in 2011. Anne enjoys quilting and swimming.

• Peter (father, 35) – Only child, no contact with his direct or extended family due to his childhood experience of family violence. Boiler maker on the NE Queensland mines, working Fly in Fly out (FIFO) 2 weeks on, 2 weeks off rotation.

  • He has a history of gambling on the horses and poker machines when he is with his friends. This has caused disharmony in his relationship with Anne.

  • Due to his family history of violence and his physical absence from the family unit, he decided his family came first and now attends Gamblers Anonymous and has built a supportive friendship circle around himself and his family.

• Steven (brother, 9 years) – Palmwoods Primary School.

• Amelie and Zoe (sisters, twins, 1 year) – Attend childcare 2 days a week on Anne’s workdays.

Extended Family

• Suzie (Anne’s sister, 30) – Office administrator (part-time, 3 days per week). Lives in Maroochydore. Married Michael in 2013.

• Michael (Suzie’s husband, 38) – Mechanic. Michael and Peter have been friends since childhood. He is supportive of Peter’s attendance at Gambler’s Anonymous.

• Josh (Suzie and Michael’s son, aged 5)

• Lucy (Suzie and Michael’s daughter, aged 8)

• Trish (Anne’s mother, 55) – Widowed, lives in Western Australia. Sees the family twice a year but keeps up with the family via Messenger several times a week.

Social Supports

• Soccer – Lucy, Steven, Jamie, and Josh play for the same soccer team. Anne and Suzie and the children catch up regularly at soccer practice and matches.

• Yoga – Anne attends yoga twice a week in Nambour and catches up for coffee and a chat with the attendees from her group. Most of those attending have children of a similar age.

• Marty (Peter’s old school friend, 36) – Panel beater, lives in Nambour.

• John (Peter’s old school friend, 35) – Mechanic, lives in Palmwoods.

  • Marty and John catch up when John is back from work and enjoy tinkering on their cars. They both have children of a similar age to Peter and Anne and catch up regularly as families.

Anne attends a local quilting group twice a month on a Saturday when either her sister or one of her friends minds the children. She enjoys this, having time away from the family to relax, chat, and catch up. It gives her time away from ‘being a mum’. She calls this ‘her sane place’.

Presenting Health Issue: ASD

Jamie has recently started year one at Palmwoods Primary School. After the recent completion of the autism spectrum disorder (ASD) diagnostic assessments following recommendation from Jamie’s teacher, Jamie has been diagnosed with ASD.

He is eligible for some NDIS funding. He will require:

• Learning assistance at school

• A behaviour management plan

• Social work assessment and development of plans to assist in developing his social skills

Anne attends Palmwoods Family Practice. Dr McIntosh has referred Jamie to a paediatrician, and forms have been completed by the practice nurse for NDIS referral. Ongoing care coordination is provided by Dr McIntosh. The school, practice, and health care provider communicate regularly, and Anne is informed by all parties involved in Jamie’s care.

Anne has found the diagnosis challenging as Jamie’s behaviour has become unpredictable since starting year one. He has become withdrawn and gets angry quickly. There have been incidences of bullying at school which has upset Anne. He still enjoys playing soccer and seems to get back to his old self when playing with his cousins.

Peter is very supportive of Anne and the family when he is home but cannot provide physical assistance when he is away. The twins are also unsettled at home due to the outbursts Jamie has. Anne finds it difficult to manage the children when he is away.

Brief of Assessment Requirements 

• Summarise the case: clearly present the family composition, living situation, and social supports (Jamie, Anne, Peter, siblings, extended family, community groups).

• Identify the health priority: Autistic Spectrum Disorder (ASD) and its immediate effects on Jamie and the family.

• Assess needs & risks: developmental, behavioural, schooling, family stressors (bullying, parental FIFO work pattern, twins’ unsettledness), and protective/social supports.

• Plan interventions: learning assistance, behaviour management plan, social skills development, NDIS referral/funding pathway, paediatric and social work referrals, school liaison.

• Care coordination & communication: show how the practice, paediatrician, school and family communicate and share care responsibilities.

• Document evidence & rationale: use clinical reasoning to justify each recommendation and link to observed behaviour and supports.

• Reflect & evaluate: measure outcomes (family engagement, school supports in place, stabilization of behaviours) and identify ongoing needs.

• Demonstrate professional skills: assessment, interprofessional referral, culturally/situationally sensitive communication, documentation, and reflective learning.

How the Academic Mentor Guided the Student 

1. Orientation to the assessment brief

   • Mentor action: Reviewed the assessment instructions with the student and highlighted required deliverables (case summary, identification of priority health issue, intervention plan, coordination, reflection).

   • Student outcome: Clear understanding of scope and marking criteria; agreed plan and deadlines.

2. Careful reading & extraction of case facts

   • Mentor action: Taught the student how to extract and record factual elements from the case (family make-up, ages, occupations, social supports, presenting behaviours).

   • Student outcome: Produced an accurate, concise case summary that preserves all provided details.

3. Problem identification and prioritisation

   • Mentor action: Guided the student to prioritise Jamie’s ASD and secondary issues (behavioural changes, bullying, family stress when Peter is away). Showed how to separate immediate safety/behaviour concerns from longer-term developmental needs.

   • Student outcome: A ranked list of needs (1. ASD supports/behaviour management; 2. School learning support; 3. Family coping strategies; 4. Referral and coordination).

4. Linking needs to appropriate interventions and services

   • Mentor action: Explained available intervention types (learning assistance, behaviour plans, social work input, NDIS referral and paediatric review) and when to use each; coached the student to match each identified need with a concrete action.

   • Student outcome: Drafted a care/intervention plan listing specific steps (NDIS referral completed, paediatric appointment, school learning assistance, behaviour management plan development, social work assessment).

5. Care coordination and communication plan

   • Mentor action: Demonstrated how to record and communicate between stakeholders (GP/Dr McIntosh, practice nurse, school, paediatrician, family). Emphasised consent, documentation and regular updates.

   • Student outcome: Prepared a communication checklist and timeline for follow-up contacts and information sharing.

6. Risk management, family dynamics and supports

   • Mentor action: Discussed family factors (FIFO father, gambling history, twins’ distress) and suggested supportive measures (parent education, support groups, leveraging social supports like soccer and quilting). Addressed when escalation or further assessment is needed.

   • Student outcome: Incorporated family-centred strategies and contingency plans in the assessment.

7. Documentation and academic presentation

   • Mentor action: Taught how to write up findings succinctly, how to reference clinical rationale, and how to present the plan in the required assessment format. Reviewed a draft and provided targeted edits.

   • Student outcome: Finalised a professionally formatted assessment that retained all case details and demonstrated clinical reasoning.

8. Reflection and learning consolidation

   • Mentor action: Asked reflective prompts (what went well, gaps, next steps) and reviewed the student’s reflective summary linking practice to theory.

   • Student outcome: Completed a reflective section demonstrating insight into practice, communication skills, and areas for future learning.

How the Outcome was Achieved

• The student produced a concise case summary that preserved the provided content (family members, supports, presenting issues).

• The student completed a prioritised needs assessment (ASD supports, behaviour management, school assistance, family coping strategies).

• A practical care plan was created with immediate tasks (NDIS referral forms completed, paediatric referral, school liaison for learning assistance and bullying management) and medium-term items (social work input, behaviour plan development).

• Communication lines and follow-up were documented (role of Dr McIntosh, practice nurse, school, paediatrician).

• The student submitted the assessment in the required format with justified recommendations and a reflective section showing learning and insight.

Learning Objectives Covered

• Clinical assessment skills: extracting relevant history from a case, identifying priority health issues (ASD) and associated risks.

• Care planning & clinical reasoning: matching needs to appropriate interventions and justifying recommendations.

• Interprofessional collaboration: understanding roles (GP, practice nurse, paediatrician, school staff, social worker) and coordinating referrals.

• Communication & documentation: producing clear written records, consent-aware communication and stakeholder updates.

• Family-centred practice: considering family structure, FIFO dynamics, social supports and how these influence care.

• Health system navigation: awareness of referral pathways and funding/NDIS processes (initiating referral steps).

• Reflective practice: self-evaluation of assessment approach, recognition of limitations and identification of further learning needs.

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