Case Study
The aim of this case study is to demonstrate how a nursing framework is used on account of a patient’s health condition. According to the NMC & the Code (2008) the patient’s right to confidentiality must be respected, therefore the patient will be addressed in the essay as Mrs Anna Molly.
Mrs Anna Molly is a 29 years old Caucasian female, who is married and has one child. She works full time as a supermarket manager. This patient suffers from a condition called Myasthenia gravis an autoimmune disease, which means that our own immune system attacks our body tissues. It results when there is a impairement in the neuromusculat transmission “ at the synapse between the termination of the axon of thye lower motor neuone an dthe muscle, at the motor end plate” (Wilkinson and Lennox, 2005, p.164). This disease is characterised by muscle weakness and abnormal fatigability (Wilkinson and Lennox, 2005, p.164). Previously being transferred to our ward Mrs Molly has been admitted in A&E with diplopia (double vision caused by eye muscle weakness in this case), dysphagia (difficulty swallowing caused by weakness of the muscles involved in this action), and difficulty speaking as her face muscles and tongue were weak (NHS Choices, no date). And also a mild dyspnoea, as the muscles involved in respiration (diaphragm and intercostals muscles) were weak. She was not able to talk clearly, and to walk without assistance. Mrs Molly explained that over the last days she have been extremely tired, reaching a point where she would need her husband to bath and dress her.
This patient was treated with a five day course of Vigam (Normal human immunoglobin) administrated intravenously, in order to decrease the symptoms of Myasthenia gravis, by changing the way her immune system was acting. After the Vigam treatment Mrs Molly was able to walk, did not need assistance, and could talk clearly. However, she still experienced problems swallowing, and she was still feeling very tired as the day progresses, but that was a symptom characteristic of her condition (Wilkinson and Lennox, 2005, p.164).
I choose to write about this patient because that was the first time I heard about Myasthenia gravis, and it is an interesting disease to research and write about .As it is an rare disease there is not much written about it, and in my opinion it is more interesting to write about a condition that is not seen regularly, such as Myasthenia gravis, rather than a condition that is more common, Parkinson’s per example.
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A framework or a model is used to create an individualised care plan for each patient; through them we can understand how nurses implement theory into practice in care, and how nursing quality of care can be improved .Nursingtheory.net (2005) says that nursing frameworks are a “collection of interrelated concepts that provides direction for nursing practice, research and education”. McKenna (1994b,p.16) believes that models are “a mental or a diagrammatic representation of care which is systematically constructed and which assists practitioners in organising their thinking about what they do, and in the transfer of their thinking into practice for the benefit of the client and the profession” (quoted in Mckenna , 1997,p.12).
The care provided by nurses used to be based in medical models, experience and intuition. The majority of the nursing textbooks were written by physicians, clergy, or psychologists, making nurses believe that they care did not need to be theoretical or logical, they simply had to follow medical orders, without questioned them (Peplau, 1987, p.18 quoted in Mckenna, 1997, p.89). Currently, nurses follow nursing models, and are trained to think theoretically.

In this essay I will be using the Roper, Logan and Tierney model (1980). This model is named after its creators: Nancy Roper, Winifred W. Logan and Alison J. Tierney, it was created to be used an education instrument for student nurses “and their