For travels with Josh every two months and

For the purpose of confidentiality the name of the case study, has been changed(UKCC 1996) The aim of this essay was to select a client, the client in thiscase being a ten-year-old boy with cystic fibrosis, in a hospital setting.

Toassess the holistic needs of that client, using Beck, Williams and RawlingsThe five dimensions of self, (Beck 1993) Josh has lived with cysticfibrosis for 7 years People with CF suffer from chronic lung problems anddigestive disorders. The lungs of people with Cystic Fibrosis become coveredwith sticky mucus, which is hard to remove and promotes infection by bacteria.Many people with CF require frequent hospitalisations and continuous use ofantibiotics, enzyme supplements, and other medications. Born and living in hull59 miles away, Josh has to be admitted to this ward every two months fortreatment, when admitted he generally remains in hospital for three weeks. Joshhas no father, but has a mother who is very protective and takes a keen interestin his care. His mother who works as a sales assistant in a small shop in hull,travels with Josh every two months and stays with him for the duration.

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Intellectual Dimension Education has been provided in hospital for many years,the 1944 education act stated that all children should be educated accordingto age, ability and aptitude (Hull 1989). One of the problems with having toattend the ward every few months is the lack of schooling Josh received, andincreased chance that he will get behind in his schoolwork. This is why it isextremely important that education and homework should continue in hospital. Theteacher on the ward that I worked came to see the children at 9am until 12pmMonday to Friday, spending around 15mins with each child. Having spoken to theteacher she said that she has to find each childs level, and work from that.

This has its benefits, giving the child the one to one tuition, however inJoshs situation, he wasnt very well, and didnt feel particularlymotivated. The last thing he felt like doing was schoolwork. The teacher didnothing to motivate Josh, she would explain what he had to do, and then leavehim until the following day. As soon as the teacher had gone, he would put thework down and do something else. It was left to the nurses on duty to motivatehim to do his work, which during busy periods was quite difficult, so regardlessof the teacher being employed by the hospital, I dont believe in Joshscase it was very useful.

Making it a little more interesting would have helped,and spending more than fifteen minutes to actually sit and go through the work,would not only ensure that he did the work but gave some contact with anotherperson Emotional The emotional state of the child is also a crucial element indevelopment and health. According The Department of Health, We now have a fargreater knowledge of how children develop both emotionally and physically. Withthat understanding has come an awareness of the emotion vulnerability of thechild and the effect which early experience can have on later development, (DOH1991) Joshs mother was very anxious about Josh and about her job, she wasfinding it incredibly difficult to hold onto jobs that allow her the time sheneeds to spend with Josh every few months. To help with the accommodation aspectof her living temporarily in Leeds, there is a building for families calledEcclesley house, which is situated in the grounds of St James hospital. Itenabled parents to be close to there children and to have all the comforts ofhome. This is not only hugely beneficial for the parent but also for the child.

It was especially advantageous for Josh and his mum, who came all the way fromHull. It was important to allow mum to be able to ask any questions she wantedand to have those questions answered in a clear legible way. It was important toallow mum to have as much hands on care for Josh as possible, giving her some ofthe responsibility of care for Josh. This is known as family centred care,Family centred care can be described as a multi-faceted concept incorporatinginteraction between child, family and nurse, to provide holistic care,(Brunner and Studdarth 1991). Providing an opportunity for the family to carefor their hospitalised child under nursing supervision, (Brunner andStuddarth 1991).

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