C.N.A.

20L
Clinical Scenario #1

You work at ABC Nursing Home on 123 Sesame St. Today is your first day back to work after being off for
the weekend. You are assigned to take care of Mrs. Ima Sickley who has recently had a Right CVA with
Left hemiplegia. She also has periods of confusion, will repeat the same questions over and over and
presses the call light frequently but does not remember doing it or what it was she wanted. She is
incontinent and requires total care for all ADLs because of the hemiplegia and confusion. Her family
visits frequently and has had difficulty accepting the recent changes.

As you are providing AM care and talking with Mrs. Sickley, you find her in good spirits. She is talkative
and cheerful. You ask her how her weekend was and she responds by telling you that yesterday, her
favorite caregiver yelled at her and slapped her while dressing her. You ask her what happened and she
tells you she doesn’t remember but tells you “she always gets mad at me but I don’t remember why”.
When you ask her the person’s name, she tells you “Oh honey, it was Mary”. You have known Mary
Smith for many years. Just as Mrs. Sickley tells you this, Mary opens the curtain and tells Mrs. Sickley to
stop lying. (Mary was caring for the resident in the next bed and overheard the conversation). Mrs.
Sickley replies “I’m not lying, you always treat me like that”. Mary tells you she is confused and is
making it up. You look at Mary and see that she is very upset about this. Answer the following
questions.

1. What should you do immediately to ensure Mrs. Sickley is protected? (2 point) I would ask Mary
Smith to please leave the room. I would then notify my charge nurse and tell her all the information
that Mrs. Sickley told me.

2. Who do you report this information to? (1 point) Inform the Charge Nurse, phone Law
Enforcement, fax the LTC Ombudsman, Law enforcement, and the Licensing Agency all within 24
hours.

3. What documentation would you do? (1 point) I would fill out a SOC341 form and I would also
document in the patients chart especially paying attention to add all details of the incident.

4. When must the written report be completed and submitted? (1 point) For this particular incident I
would complete and submit the report immediately within 24 hours.

5. You are told that the Administrator will be informed and he will take care of reporting the incident,
what should you do? (1 point) I would tell them that I am going to report it as well because I am
also a mandated reporter and I was the one verbally notified about the abuse from the resident so it
is my duty to ensure the proper documentation is given to the correct people.
6. Who is responsible for completing the report? (1 point) For this particular incident I am the one
responsible for completing the report because I was told about the abuse by the resident.

7. Complete the report on the next page using the info from this face sheet. (3 points)

Name: Ima Sickley DOB: 1/1/1935 Age: 84 Gender: Female

Responsible Party: R.U. Sickley (spouse) Social Security: 999-99-9999
Address: 9 Elm St, Sunnyside, CA 99999 Ethnicity: Caucasian
Phone: 222-555-1212 Physician: Dr. Geri Atrick