Case Study Robert Morris is 25 years old. He is in rehabilitation following a spinal cord injury that resulted from falling off his parents' roof...

Case Study

Robert Morris is 25 years old. He is in rehabilitation following a spinal cord injury that resulted from falling off his parents' roof while cleaning the gutters. He lost his balance and fell two stories to the ground fracturing his L1 vertebrae. Robert had a job in the marketing department of a large department store in a town 15 miles away. He doesn't think he will be able to remain in the job after his injury. He currently is on medical leave of absence.

Mr. Morris is engaged to Laura Knecht, 25 years old and recently graduated and an occupational therapist. She is employed by a local hospital. They have dated since high school and have always planned to marry. Laura has been very supportive of Robert during his convalescence, but he has been noticeably cool and withdrawn toward her. Robert plans to live with his parent when he is discharge. They are concerned about Robert's treatment toward her. His 18-year-old sister has been giving him a hard time about how he is treating Laura.

Mr. Morris is paralyzed from the waist down and the physicians do not know if the paralysis is permanent or not. Robert has spent 4 weeks in the rehabilitation hospital and is planning for discharge, after which he will receive physical therapy in the home. You are the home health nurse visiting Robert in the rehabilitation center to obtain a current assessment and begin developing his plan of care.

Question 1

How should you respond to Robert if he confides in his concerns that he will never be able to hold a decent job or have a family?

Question 2

Why might Robert be attempting to distance himself from his fiancée? How should you address this issue?

Question 3

Design Robert's initial plan of care for his first week at home.