THE GERAINT FAMILY Richard Geraint is a 42 year old man living in Torrington, a small village about 170 km from Armidale

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THE GERAINT FAMILY
Richard Geraint is a 42 year old man living in Torrington, asmall village about 170 km from Armidale in the Northern Tablelandsof NSW. Richard is married to Maureen (age 37 years).
Richard and Maureen have 5 children. Jason (21 years) is theeldest, followed by Jill (19 years), Jenny (17 years), Jack (15years) and Jessica (14 years).
Maureen works at the Woolworths at Glen Innes but unfortunatelyher shifts do not often match Jack and Jessica’s school hours.
Richard has worked at the local sawmill all his life. He becamethe foreman about 6 years ago when his predecessor retired butworries about the long-term prospects for work. The sawmill employs12 people, but in its heyday, it had 60. In those days, the villagehad 1000 residents and a large school that was a combined primaryand high school and thriving commercial sector. As the timberindustry gradually declined, so did the village population.Presently, there is only a general store/café/petrol outlet as wellas the hotel, which is struggling to keep its doors open.
Jason did not like schoolwork, but loved sport and was good atrugby league, cricket, athletics, horse riding and just about anyother sporting activity. He announced to his parents at barely age16 that he was quitting school to work full time. Jason had alreadybeen working part-time on Saturday mornings and school holidays asa labourer in the sawmill. When he started full time work at thesawmill, he seemed much happier. He started going out with Penny,whose parents own a beef cattle property. Penny is at boardingschool, and her parents want her to go on to university afterfinishing school at the end of the year. She loves the outdoors andshe and Jason enjoy bush walking, camping and playing manysports.
JASON HAS AN ACCIDENT
Jason was driving home with his dad in the car when a car comingthe other way overtook a semi-trailer. This car lost control andside swiped Jason and Richard's vehicle before colliding with atree. Jason swerved to avoid the oncoming vehicle, lostcontrol, and collided with the semi-trailer. The truck thenleft the road, hitting a tree head on.
The Police, Ambulance, SES and Fire Service all attended theaccident. It took nearly an hour for them to arrive from GlenInnes. Both Richard and Jason had to be cut out of the car wreck.There was concern that the car could ignite due to spilt fuelduring the rescue. It was a chaotic scene with Jason unconsciousand very badly injured. His father was screaming in pain andalso distraught about his son. As it was a rural road, an airambulance was the quickest on the scene. Jason, who was moreseriously injured, was flown to the Armidale Hospital with a doctorand nurse on board. Richard was transported to the same hospitalvia road ambulance. The truck driver was also critically injuredand was transported to the hospital by road ambulance.
Upon arrival at Armidale Hospital Jason was attended to by theEmergency Department (ED) staff. Jason’s right arm was almostsevered, he had a broken pelvis and both legs were fractured. Jasonhad internal bleeding along with multiple lacerations and minorinjuries to his face and head. He was unconscious and there wasuncertainty whether he had a brain injury. Richard arrived at theArmidale Hospital about an hour later; he was also severely injuredbut conscious. His right tibia (lower leg) was fractured. He hasinternal bleeding, broken ribs, a suspected spinal injury and afull-thickness laceration on his scalp. The truck driver, Jim,arrived around the same time as Richard and has a severe injury tohis chest from hitting the steering wheel, internal injuries aswell as a possible fractured neck.
The ED team triaged Jason and addressed the most immediate lifethreatening injuries. He was sent for radiography and medicalimaging of his injuries. His is assessed as being in criticalcondition. The decision is made to urgently transfer Jason to alarger hospital, the doctors deciding that the John Hunter Hospitalat Newcastle is the appropriate place for Jason's ongoing traumacare. Richard and the Jim are both assessed medically serious butstable, can remain in Armidale and are admitted into the ArmidaleIntensive Care Unit (ICU).
The Geraint family is notified of the accident and that Richardand Jason are at the Armidale Hospital. They are informed thatJason is being prepared for retrieval to the much larger JohnHunter Hospital nearly 400 km away due to the nature of his trauma,and that the hospital social worker will meet the family atArmidale hospital upon their arrival.
JASON IS TRANSFERRED TO GLENAURIE
Jason is transferred overnight to the ICU at John HunterHospital, and he is still unconscious on arrival.
You are a healthcare professional at John Hunter HospitalICU. When you start work, you are advised that Jason is a newadmission via an inter-hospital transfer from Armidale Hospital,where he received initial treatment following a motor vehicleaccident. You examine the medical records and become aware thatJason and his father were involved in the accident. Jason's fatherremains in a serious condition at Armidale with significant trauma.At the morning ‘rounds’ with the ICU team you are acquainted withJason’s medical condition. You see that there are ongoinginvestigations to determine the precise extent of his injuries.
Jason’s injuries include:
He has continued Loss of consciousness and isbreathing with the support of a ventilator.The most serious is the head injury, requiring an immediateoperation to relieve swelling on the brain, the swelling likelyresulting in an acquired brain injury of yet indeterminate impact.In addition, the injuries to his right arm reveal that injuries areso serious that the arm cannot be repaired. The decision is made toamputate the arm, to alleviate further complications such assignificant infection and further delay Jasons recoverypathway.
Maureen and the children regularly visit Richard in the ArmidaleHospital. They are trying to organise one family member to travelto John Hunter Hospital to be with Jason. However, they find thatgetting information from the ICU staff over the phone is difficult,if not impossible. Although some of the doctors and nurses havetried ringing Maureen’s mobile phone she is cannot receive thecalls when she is at work. Her employer is supportive, but thereare rules against staff carrying their mobiles, so all she isgetting is short messages. She has tried to talk to the ArmidaleHospital social workers. However, she has found that they notoften in their office but are instead in other parts of thehospital attending to other patients and their families.
Money is very tight for the family. Although the accidentoccurred during their return from work which is covered by theWorkCover NSW scheme, there are nonetheless considerable delaysaccessing payment as there are a many forms to be completed.Maureen makes a decision to go to see the social worker in theArmidale Hospital about her situation. She is worried about her sonand has been finding it hard to sleep.
JASON'S SURGERY ANDRECOVERY
The Armidale Hospital social worker contacts the social workerat John Hunter Hospital about Jason Geraint. The two social workerswork together to see what assistance is available to Jason’s motherMaureen for travel to Newcastle to be with her son. They identifythe Isolated Patient’s Travel Assistance Scheme (IPTAS) run byEnableNSW to see whether it will help non-patients who have travelaway to be with an ill or injured loved one in a NSW Healthhospital.
A week passes, and Jason has several operations to address theswelling on his brain, including a shunt to release fluid. Hisright arm is amputated, and some work is done on his internalinjuries. He is a young man and recovers from these quickly, and heregains consciousness. However, he is nonetheless suffering fromthe impacts of his injuries. He is in pain, and his acquiredbrain injury is leaving him confused and dazed. Jason istransferred to the John Hunter Hospital Orthopaedic Ward from theICU. He is most pleased to see that his mother is there to stay fora while but remains confused and disorientated.
Over the next two months he begins the long journey for hisrecovery and rehabilitation. A variety of healthcare professionalsare engaged in this healing process. Over time Jason receives helpfrom the physiotherapists regarding his physical injuries andphysical movement. Speech therapists work with him onre-learning to talk. He also sees a clinical psychologist whoassists with determining the extent of his mental impairment. Anoccupational therapist assesses his injuries and likelyrehabilitation requirements. Pharmacists are closely involved withhis medication and the possible side effects and reactions whendifferent drugs are combined. Dieticians work on his food intake tomake sure that he is eating healthily. For Jason, their workhas been truly lifesaving. However, as he prepares to bedischarged from hospital, his journey to recovery has onlystarted.
Your task:
Review the Case Study, and then writean essay to:
(a) Identify theprincipal stakeholders involved inJason's care in the two months between admission and discharge,and briefly describe each of theirroles.
(b)Identify key peak bodies who may assist with Jason's ongoing health issues post discharge,focussing on:
Describe the services available to Jasonand his family in a best-practicescenario, and the ways thesewould ideally communicate andinteract.
(c) Criticallyanalyse the realities ofthe support that Jason and his family may receive in the threemonths after Jason's discharge from hospital.