Discharge planning for a client from a northern community
IENCAP OSCE practice station

The task

You are the nurse on a medical unit in Ontario. Joanne Whitefish, aged 49, is an Anishinaabe woman from a northern community who has been in hospital for five days with an infected foot ulcer from diabetes. She is due to go home tomorrow and you are to explain the dressing changes and follow-up. No other staff are present. Introduce yourself and begin the conversation. Provide care in a way that is respectful and culturally safe. Explore what she needs for a safe plan. Record the plan in the note provided.

What this station tests

• Ask how a client wishes to be addressed and what matters to them; do not assume.
• Listen first. Do not label a client non-compliant when access or transport is the barrier.
• Ask openly about traditional healing and offer an Indigenous patient navigator, leaving the choice to the client.
• Build the plan around the client's community, supports and the services that exist there.
• Cultural safety is judged by the client's experience. Record strengths as well as barriers.

Sources for the clinical content

• RNAO Best Practice Guideline: Diabetic foot ulcers
• Indigenous Services Canada: Non-Insured Health Benefits, medical transportation
• National Collaborating Centre for Indigenous Health: Indigenous cultural safety in Ontario

An original practice scenario with invented patients. Not an exam question.

Practise next

• A client who is thinking of cancelling surgery