1(a) Describe one problem and propose at least one patient goal (in SMART format) for the patient case. Why is this goal appropriate for the problem and for the individual patient? What psychological or social factors might present barriers to goal achievement?
1(b) Design a care plan for your selected patient case that includes:
Two identified problems
Three or four goals
Three or four interventions
Justification for the care plan (i.e., Why is it appropriate for the patient?)

Explanation of how you would advocate for this plan within the IDT and achieve buy-in from the patient, caregiver, and other members
Samantha
Samantha Polaski is a 14-year-old Caucasian female who lives at home with her
mother, Lauren, and her father, David.
Episode
Lauren rushed her daughter to the hospital after finding her unresponsive in her
bedroom one afternoon. Samantha was stabilized in the emergency room through IV
fluids and monitored further. Samantha denied taking any drugs or alcohol and reported
she had been feeling “lightheaded” and “nervous” lately. After lab tests and physical
examination ruled out an obvious medical cause, the ER doctor ordered a psychiatric
consult. The psychiatrist recommended admission to the hospital’s behavioral health
unit. Samantha was transferred there and began treatment with an interdisciplinary
team of Dr. Turner, a psychiatrist; Tayo, a nurse; and a social worker.
Signs of Anxiety
Samantha reported a recent history of anxiety and depression, centering around the
demands of school and her social life with peers. She said she had many friends in
junior high but that since starting high school, those friends seemed to fall away.
Samantha did not participate in sports or extracurricular activities, though she admits
running on her own. In fact, she said recently she had increased her daily jogs to
multiple miles to try to address the elevated anxiety she was feeling. She stated that
running was “the only time I feel like me.”
Samantha reported one prior episode in which she temporarily lost consciousness. It
was during her first midterm exam in high school. She felt her heart quickly begin to
race and pound loudly in her ears, and she had trouble getting air. She fainted but was
able to recover quickly in the school’s health office. She reported that her peers now
“stare at me” due to this incident.
Vaccine
As part of Samantha’s stay at the hospital, nurse Tayo mentioned administering the
COVID-19 vaccine if she and the parents would like. During the conversation with the
nurse, Samantha became tearful and related how her father was against the vaccine,
fearing side effects. The night prior to Samantha’s arrival at the hospital, in fact, her
father had argued with her mother that cases for minors were mild and that Samantha
did not need a vaccine right away. He felt that the risks were unknown, and he wanted
to wait until more children were vaccinated.
Samantha reported overhearing the conversation, and while she initially wanted to get
vaccinated, her father’s comments left her frightened. So much talk about the vaccine
had left her feeling very anxious, and she could not sleep at all. This lack of sleep led to
increased anxiety on the day of the episode.
Due to Samantha’s worry surrounding the vaccine, nurse Tayo and the team decided
not to continue offering vaccination and to allow the family to work through the topic on
their own after discharge.
Care and Discharge Planning
After 2 days, the social worker discussed with the parents that Samantha was ready to
be discharged to outpatient care. David expressed that he did not want Samantha to
receive any treatment whatsoever and certainly didn’t believe she belonged in inpatient
care, whereas Lauren did not think Samantha was ready for discharge yet. “She’s safe
here,” Lauren stated. “Maybe she needs psychiatric care, David. I don’t want to find her
like that again.”
When asked what she wanted, Samantha said, “I’m just so … tired. I want to sleep.”
Consider the following questions as you take on the role of the social worker and
develop the discharge plan in Week 10:
1. What are two social aspects to consider when developing a discharge plan for
Samantha? How would you include the team in the decision-making process?
2. How would you include other team members in providing education to this
family?
3. How would you reconcile the differing opinions of Samantha’s mother and father
and also consider her needs and wishes?