Andrea, a 15 year old girl is in the admissions unit suffering from persistent vomiting. She looks pale, listless and feels faint. On initial assessment her blood pressure is low and she is dehydrated. She complains of abdominal pain. The doctor explains to Andrea that this is to be expected when she is vomiting so much, but she probably has a tummy bug that has been going round. Andrea, who has Down’s syndrome, says ‘will I be well enough to get back to school this week? I have exams soon and don’t want to miss anything’. The doctor replies, maybe, I just need to examine your tummy and take some blood. Andrea says she doesn’t like needles and reaches out for her Mum, who holds her still while blood is taken.
The doctor walks out of the room with the blood sample and goes to find the nurse in the ward mangers office. She shuts the office door then says to the nurse ‘What should I make of this? Andrea is 22 weeks pregnant! Guess that explains the vomiting, but I don’t think Andrea or her mother had any idea about it’
Reading
NHS Choices:
http://www.nhs.uk/conditions/Abortion/Pages/Introduction.aspx
Restrictive physical intervention and therapeutic holding for children and young people. Guidance for nurses
British Institute for Learning disabilities information (There are several documents here. Once you open the page, scroll down to find everything).
http://www.bild.org.uk/information/relationships/marriage-to-abortion/#Pregnancy-babies-and-parenting
News report - what are the issues affecting decision making here?
http://www.independent.co.uk/news/uk/home-news/motherofsix-with-learning-disabilities-could-be-sterilised-after-authorities-ask-court-for-permission-to-force-entry-into-her-home-10018414.html
The video and study in the links below consider work from Sweden exploring Intellectual Disability and pregnancy outcomes
https://www.youtube.com/watch?v=tCJg1tGpn6c
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549474/
Look at the information in the links above and attached guidance documents relating to parenting and disability. Find your own evidence too - Y ou can post on the board to share with colleagues and maybe use in assignment work.
What are the issues here? What are the implications for professsional nursing and fields of practice?
Once you have thought about this you should:
1. Vote on the proposal below
2. Share some of your reasons for making the decision to vote as you do
3. Look at the case results and read comments from some other students
4. Post a reply to at least one other person
5. Be prepared to discuss this issue in your seminar group
NOTE: You may also use your reflections related to this case in relation to demonstrating achievment and EU directives / exposure to fields of practice for your portfolio
It is proposed that Andrea's mother should decide whether or not the pregnancy should continue