Group Activity #5-Case Study (Case of Joella Sanchez)

Total Points: 25 Points

CRITICAL THINKING CARE STUDY

Joella Sanchez is a 22-year-old woman who just realized she is pregnant. She is delighted with the
news, and so she was surprised to hear her 4-year-old daughter, Michelle, scream that she didn’t
want a brother or sister. Joella and Michelle both live with Joella’s mother in a two-bedroom house.
Her mother’s reaction to learning about the pregnancy was to ask, “How will I fit another crib in
here?” Joella works nights as a nurse’s assistant at a local nursing home. Her supervisor’s reaction
was to frown and say, “Don’t ask me to change your work schedule because you’re tired all the
time.”

1. Is Michelle’s reaction to learning a new sibling is on the way unusual? What could Joella do
to win her over about the new baby?

As young as she is, Michelle does not understand the pleasant side of having a new sibling
just yet. Freud, a psychoanalytic theorist, has emphasized the stressful nature of this
transition for firstborn children. Often citing it as one of the most traumatic experiences of
early childhood. Michelle is not obliged to do the adjustment of this transition overnight.
It is very important for Joella to consider the feelings of her firstborn. Parental attention
must be taken into action since it is clearly stated that Michelle is just living with her mother
and grandmother, without the presence of her father under the same roof. As a mother,
Joella must understand that before stepping up to a new level of being a mother, Michelle
must feel that she will not to be left out during the transition. It is best for Joella to allocate
most of her free time to her firstborn. Let Michelle feel that what is inside her mother’s
womb is not a foe, rather a best friend. Make her feel excited by telling her the importance
of having someone she can play with and accompany her in the future. The mother-
daughter bond will be an effective way to make Michelle accept the baby inside the womb
as well.

2. Both Joella’s mother and her work supervisor do not sound happy about the new baby either.
What could Joella do to win them over?

It is a normal reaction for a mother who still supports her single mom-daughter, to be
slightly disappointed about the news. Knowing how hard it is for her daughter to juggle
everything without the help of a partner, this made Joella’s mother say such harsh response.
At times like this, it is natural for Joella to feel unsecured and unwelcomed. Yet she has to
understand as well her mother’s indirect disapproval. Although her mother may sound
unhappy about the news, eventually she will accept what her daughter had done. Joella has
to prove to her mother that she is willing to take the responsibility of her action and work
some more. The same goes with her work supervisor. The response she received is a normal
reaction of someone who has to consider as well the other setting that is about to be changed
because of Joella’s condition. She has to understand it as well. But as a pregnant woman,
she has the right to demand for adjustments for the sake of her baby. She could still be a
 regular employee but should refuse to go to work if her body does not permit so. Joella
must not let discouragement get in her way. She could allow her supervisor to give her
possible options for her work.

3. Joella is happy about her pregnancy but surrounded by a circle of negative reactions. Could
this affect her acceptance of the pregnancy? What patient education can you provide to assist
her in responding to these reactions?

Joella needs to know the right thing to do when dealing with this kind of responses. The
first thing a nurse needs to do is to listen to Joella’s feelings and discuss the matter without
judgement. Let Joella feel that she could still do something to overpower her fears and low
self-esteem. After listening to her sentiments, allow her to talk about her own plans about
this situation since she is the one who knows better about the matter. After which, educate
her about what is needed to be done in order to facilitate good childbearing stage. Educate
her to be more motherly than anything else by taking much responsibility on the situation.
Always remind her to focus mainly on the health of her child. Differentiate possible
outcomes if she fails to maintain a healthy process. Let Joella apply her own principles
independently if she refuses to change her ways.

Reference:
Bull, P. (2017). Family Transitions Following the Birth of a Sibling: An Empirical Review
of Changes in the Firstborn’s Adjustment. PMC US National Library of Medicine.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341504/