Case study 28.2

Possible answer to: What do you think about Gayle’s initial contact with the ward?

Some questions that may help you form an opinion include:

• Was any attempt made to contact Gayle before she visited?
• What information was available for Gayle to access before visiting, in what form was this information (i.e. verbal, written, online), and how easy was it to access this information?
• Did any member of the nursing team initiate contact with Gayle when she first visited the ward or did Gayle need to approach staff?
• How relevant to Gayle was the information leaflet she obtained from the nurse in charge?
• How helpful was Gayle’s conversation with the nurse in charge in giving relevant information to Gayle at the time and in ensuring contact was able to be made between Dwayne’s key nurse and Gayle.

Possible answer to: Gayle asked questions about Dwayne’s condition and progress. If you were Dwayne’s key worker, how would you respond to Gayle?

In relation to responding to questions about Dwayne’s condition and progress, the initial discussion may need to include an acknowledgement of the limits to what specific information about Dwayne’s care and treatment can be disclosed due to the need to retain confidentiality. This discussion is not required if Dwayne has already consented to information being shared. Gayle should be informed what information about Dwayne is able to be divulged. Reference can be made to any service confidentiality guidelines. It would be helpful to allow Gayle to spend some time to express her views about any restrictions on information provided. It is also important to inform Gayle that the duty of confidentiality also applies to information received from carers. 

As Dwayne’s key worker, if Dwayne has not given permission for information to be shared with Gayle, it is important that you are able to distinguish between the specific information about Dwayne’s care and treatment and more general information about the care and treatment of someone with mental health problems. You would be able to discuss the latter with Gayle without breaching confidentiality. This could include discussions about what may cause psychotic episodes and the likelihood of her other two sons developing mental health problems. In addition, specific areas relevant to Gayle would be able to be discussed. This would include Gayle’s role at Dwayne’s upcoming case conference as well as information about the structure of the meeting, who would be attending, the time and length of the meeting and questions Gayle may want to ask. Directing Gayle to any written or online information about the unit’s case conferences would also be useful.