NUR4636 \u2013 Community Health Nursing
\nPage 1 of 2
\nCase Study
\nChapter 29
\nIssues with Rural, Migrant, and Urban Health Care
\nMarty, a 75-year-old male, with a history of myocardial infarction called home
\ncomplaining of heartburn and running out of antacids. When his daughter-in-law
\nreminded him to maintain his rest and diet times, Marty grew angry. \u201cKnock it off. I
\nam doing fine despite what the doctor said. I will care for the diabetes after the
\nharvest and I will come home as soon as I can.\u201d
\nDriving his combine formation with other workers for a night harvest, Marty
\npaused at 9:45 PM for a break while the rest of the combine formation continued
\nmoving forward. Marty\u2019s 6-year-old grandson rode in the combine with him to
\nexperience his first night harvest. No further communication was received from
\nMarty\u2019s combine.
\nThe boy\u2019s mother called again at 10:00 PM with no answer. Used to \u201cfarm
\ntime\u201d and dead space for the cell phones, she was not overly worried but was
\nconcerned about her son being out so late at night. The mother called her spouse
\nwho drove another combine in a different field to find out why the boy was not yet
\nhome. The father dispatched a truck to find Marty while the combines continued
\nharvesting and gleaning.
\nThe truck driver found the missing combine on its side in a gully with the
\nlights shining upward. A satellite phone was used to notify the Northern Air
\nAmbulance and the local 911 of GPS coordinates. The volunteer flight and
\nparamedic teams were dispatched. The Italian-made Agusta Power-109 helicopter
\nused instruments to fly over two counties of hilly terrain. The single pilot employed
\nnight vision goggles to study the instrument panel and the radio to keep the pilot
\ninformed of ground rescue operations and hospital preparations. The flight nurses
\ndouble checked the laryngoscopes, blood supplies, and jump kits while maintaining
\ncontact with the first scene arrivals.
\nNUR4636 \u2013 Community Health Nursing
\nPage 2 of 2
\nWhen the paramedic vehicle arrived, an employee truck was seen driving
\naway from the combine. Marty was unconscious with a weak, irregular pulse of 100,
\nBP of 65\/48, and respirations of 26. A bruise over the right mastoid is noticed. The
\ngrandson is conscious and crying, splinted for a broken leg. His pulse is 120, BP
\n138\/118, and respirations of 24. Purple circles are seen around his eyes. The 6-
\nyear-old complains of a headache and calls for his mother.
\n1. How will the nurse gather needed information to effect a successful rescue?
\n2. What travel and emergency transport resources are available?
\n3. What rural barriers to diagnosis, treatment, and follow-up resources exist?
\n4. What roles do rural nursing theory principles play in Marty\u2019s health
\nbehaviors?
\n5. The nearest critical access hospital does not have a trauma level due to the
\nlack of a 24-hour staff with trauma training. What types of trauma support
\ndo patient needs indicate?<\/p>\n","protected":false},"excerpt":{"rendered":"
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