Dominik Obraski’s Case Study Essay Example For College


This assignment examines the health problems experienced by Dominik Obraski in the case study. Dominik is a 68-year-old who has been diagnosed with chronic obstructive pulmonary disorder (COPD). He also suffers from depression following his wife’s death 18 months ago. Dominik is a heavy smoker and has been experiencing shortness of breath since her wife’s death. This assignment will examine the biological, psychological, and social factors influencing Dominik’s health. It will also explore the ethical, legal, and professional components regarding the nursing process, health promotion, and communication.

Biopsychosocial Factors

According to the biopsychosocial model, illness arises as a result of a complex interaction between biological components, psychological components, and social components (Smith, 2021). The model works by providing the service user with holistic care while treating them as a whole person, considering their physical, psychological, and social problems when delivering treatment rather than only treating the illness (Smith, 2021). This is because these elements are clearly related to one another; if one is impacted, it is very probable that the others will be as well.

Chronic obstructive pulmonary disease (COPD) involves several progressive lung disorders. Emphysema and chronic bronchitis are the most prevalent illnesses. When one is diagnosed with COPD, mucus begins to accumulate inside the tubes, restricting proper ventilation and eventually leading to respiratory issues (Gerayeli et al., 2021). Smoking and ongoing exposure to irritating chemicals are the two main causes of COPD. The patient is likely to experience hyperinflation of the lungs and gradual, partially reversible airflow restriction (Gerayeli et al., 2021).

According to the case study, Dominik has smoked his entire life, which has exposed him to long-term irritating harmful substances. As a result, Dominik is more prone to developing lung obstruction and airflow hyperinflation. Breathlessness is one of the signs of COPD (Flynn and Mercer, 2018). In order to choose the best clinical application, nurses must comprehend the pathophysiology of the condition. Nurses can measure and evaluate Dominik’s cigarette consumption with a brief intervention, a strategy for health promotion used by the Make Every Contact Count (MECC) initiative. Five steps can be used to do this: ask, advise, assess, assist, and arrange. Dominik’s smoking status can be recognized by the nurse, who can then ask the right questions to record his daily intake. It is the nurses’ job not only to help Dominik in quitting but also to encourage him to quit by giving him clear instructions and tailored counsel (Kusnanto et al., 2018). The nurse should help Dominik stop smoking with behavioral assistance; this can be accomplished with the use of universal e-cigarettes or pharmacological aids. Additionally, if Dominik is not ready to quit, it is the nurse’s responsibility to support and encourage future attempts to quit. The nurse should also conduct follow-up appointments within a short period of assessment time and recommend Dominik to a professional cessation service for assistance (Howatson-Jones et al., 2020).

Dominik’s Biopsychosocial Model of Health includes bereavement as a psychological component. Psychological elements such as emotions, cognitive functions, and behavioral tendencies may have an impact on our thoughts, feelings, and behaviors (Kusnanto et al., 2018). This case study strongly implies that Dominik is going through grieving as a direct result of his wife’s death. When a person loses a loved one, bereavement occurs, and the person is thereafter overcome with grief as a result of the loss (Kusnanto et al., 2018). Signs of grief are an indication of a strong sense of guilt the person is going through. Additional signs of sadness include a poor diet, a lack of personal hygiene, and the loss of one’s job.

Dominik may be experiencing depression since he may feel helpless and overwhelmed at this point in his grieving process. Depression is a problem that affects people of all ages worldwide and dramatically increases the risk of certain risk factors (Barberio et al., 2020). Reduced energy, poor attention, loneliness, sleep deprivation, and a sense of low self-worth are the consequences. Typically, these symptoms develop into chronic conditions that make it difficult for a person to carry out daily tasks (Faris, 2020). This psychological component clarifies Obarski’s incapacity to cook and tidy the house. The nursing profession must uncover the root of Mr. Obarski’s incapacity to complete tasks in order to determine the appropriate treatment plans for the patient, such as light physical activity and the adoption of an effective communication model during the healing process.

The Role of Nurse in Caring for Mr. Obarski

In order to meet patients’ demands and protect their health and welfare, nurses must use verbal and nonverbal communication (Nursing and Midwifery Council, 2018). Empathy is “the capacity to recognize and accept another’s feelings without imposing one’s own.” Empathy helps the nurse comprehend Dominik’s loss to improve his mental health. To assist him in coping with his loss, the nurse should gain his trust and cultivate a positive relationship with him (Barberio et al., 2020). Dominik is likely to benefit from the nurse’s attentive listening because it enables him to confide in the nurse about his loneliness and loss.

Social isolation is the social component in Dominik’s case study. Social isolation has been linked to depression and continues to be detrimental to a person’s physical, mental, and cognitive well-being (Flynn and Mercer, 2018). Dominik decided to live alone and distance himself from other people after losing Eleanor. His current state and the urgent need for medical attention are directly related to the effects of his loss. Prior to the passing of his wife Eleanor, Dominik enjoyed a vibrant social life, yet, he was severely sociologically unbalanced. The nurse’s job is to provide patients a reason to view their problems from a different, more wired perspective during her encounters with them. (Varkey, 2020). The nurse should talk to Dominik, spend time with him, and find out about his interests and activities in order to develop a practitioner-patient relationship with him and promote trust.

The term “ethics” refers to the moral standards that all nurses should uphold in order to develop an ethically-driven treatment philosophy. It is expected of all nurses to uphold these moral principles (NMC, 2018). The ethical notions of beneficence, non-maleficence, autonomy, and justice are connected and rely upon one another within the framework of “principles” (Trujillo, Jr., 2021). According to the NMC (2018), “beneficence” is defined as “doing good and promoting best interest,” and nurses are urged to live up to this crucial duty of deontology. The nurse exemplifies the virtue of beneficence by prioritizing the use of constructive strategies while she works to improve Dominik’s health.

For instance, the nurse arranges for Dominik to be visited following repeated failed attempts to visit him on her own through Clara. In doing this, she enables herself to put Dominik’s needs first and act in his best interests. The beneficence principle is crucial in this case study because if Dominik’s COPD is not examined, his untreated symptoms could result in an exacerbation, which could be fatal (Faris, 2020). Due to this, Dominik’s social and psychological well-being is in danger of declining. As a result, the nurse must think about what is in the best interest of the patient and avoid harm (in a non-maleficent manner) without adding to Dominik’s mental anguish caused by his grief.

For Dominik to receive risk-free nursing care, the rule of law is essential. The Mental Health Act of 1983 protects Dominik’s well-being and authorizes nurses to carry out examinations and offer assistance in this area (Barberio et al., 2020). Unless it can be demonstrated differently, it is reasonable to assume Dominik has the ability because the case study does not establish that he has a mental health problem. Despite declining hospitalization, Dominik appears to pose a threat to his health. In accordance with the code’s Section 17.1, nurses are required to take reasonable measures to protect those who are vulnerable to harm, neglect, or abuse (NMC,2 018). By having an untidy home, food that has gone bad in the refrigerator, and a lack of personal hygiene, Dominik is showing signs of self-neglect.

In order to protect Dominik’s safety, it is the nurse’s responsibility to promptly contact the local authorities, including the police (NMC,2018). Dominik must be made aware of how these regulations are beneficial to his overall health, according to the nurse. Section 135 of the Mental Health Act permits the police to enter Dominik’s home (Mental Health Act,1983). By doing this, the police will be able to use the act to move Dominik to a secure location where he may get medical assistance if necessary.

Prioritizing people, successfully performing one’s job, protecting one’s safety, and promoting professionalism while simultaneously building trust in one’s chosen sector are the four characteristics of professionalism (NMC, 2018). These ingredients are required to maintain Dominik’s health in its present condition. Article 1.5 of the Code of Ethics for Nurses states that nurses must “respect and uphold people’s human rights.” This criterion is anticipated to be followed by nurses. The nurse has a responsibility to ensure that Dominik’s human rights are not abused in any way when attempting to reach him for assessment purposes (Howatson-Jones et al., 2020).

In conclusion, Dominik’s biological, psychological, and social needs were completed with a special focus on the nurse’s tasks in relation to communication strategies and the promotion of health. Numerous protocols, methods, and tactics are combined into a holistic framework, with Dominik’s safety and needs as the first priority. Additionally, they give him the chance to take part in his care, allowing him to keep his dignity and independence, as is emphasized in good nursing practice.


Barberio, B., Zamani, M., Black, C. J., Savarino, E. V., & Ford, A. C. (2021). Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology6(5), 359-370.

Gerayeli, F.V., Milne, S., Cheung, C., Li, X., Yang, C.W.T., Tam, A., Choi, L.H., Bae, A. and Sin, D.D., 2021. COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine33, p.100789.

Faris, S., 2020. Recognizing Serious COPD Complications. [online] Healthline. Available at:

Flynn, M. and Mercer, D., (2018). Oxford Handbook of Adult Nursing. 2nd ed. Oxford University Press, p.170.

Howatson-Jones, L., Standing, M. and Roberts, S. (2020). Patient assessment and care planning in nursing. 3rd ed. p.98.

Kusnanto, H., Agustian, D. and Hilmanto, D., 2018. Biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of family medicine and primary care7(3), p.497. 1983. Mental Health Act 1983. [online] Available at: NHS Health Education England. (2022). Make Every Con [online] Available at:,Makingeverycontactcount(MECC)isanapproachtobehaviour,ofindividualscommunitiesandpopulations. 2018. Future nurse: Standards of proficiency for registered nurses. [online] Available at: 2018. Professional standards of practice and behaviours for nurses, midwives and nursing associates. [online] Available at:

Smith, R. C. 2021. Making the biopsychosocial model more scientific—its general and specific models. Social Science & Medicine272, 113568.

Trujillo, Jr., G., 2021. Principlism in Biomedical Ethics: Respect for Autonomy, Non-Maleficence, Beneficence, and Justice. [online] 1000-Word Philosophy: An Introductory Anthology. Available at:

Varkey, B., 2020. Principles of clinical ethics and their application to practice. [online] Karger. Available at:

Downsizing With Dignity Essay Sample For College

Downsizing is the act of reducing the number of employees in an organization to achieve a specific objective. Companies reduce employees: the need to cut expenses costs when relocating a company to a different region or country and adopting new technology that will replace human labour (“Definition of Downsizing – Gartner Human Resources Glossary”, 2022). The paper will discuss the article “Downsizing with dignity”, its considerations, impacts on the remaining employee, and the experimental process of downsizing.

It is a problematic method even during monetary strains in an organization. The legal management of the organization does it. Most organizations assume the symptoms of early retirement until it is too late that they act rapidly to reduce the monetary drain of many workers. Moreover, less attention is given to the workers to be discharged, the amount of compensation, and the extent to which the firm will help them find other jobs. Furthermore, the afterlife of the laid-off workers is as important as the firm’s future. Choices are made by the lawful sector, whose primary goal is to minimize the probability of the action.

Further, the process is done rapidly, leaving those laid off annoyed and the existing ones vulnerable and discouraged. Lastly, vulnerability is the opposition to high accomplishment because it leads to a lot of blame shifting and reduced morale. It, therefore, acts as an encouragement to collapse the organization rather than a motivation to succeed (Downs, 2011. pp.1).

In addition, the ineffective method that an organization uses during downsizing is permitting lawful interest to plan early retirement in that most management piece of advice is that the organization should use the last employed first dismissed strategy covering all the departments. So, no worker can say they were discriminated against during the process, and the management is told not to promise the workers anything since they may not fulfil it. The strategy may be successful and lawful but not organizational since they need to consider the areas that need more workers than others to implement. Furthermore, not all departments need the same number of workers, so the organization should countercheck for the departments that will need the necessary number of workers that can work in the meantime. Secondly, granting as little awareness as possible in that most management fear that when employees are told in advance, they will be dismissed, demoralized, and sabotage the company; hence most of them give hints or rather keep quiet about the information. The strategy reduces the trust between the existing employees and the management. Lastly, after the early retirement, most management acts as if nothing has happened, but employees should be given time to talk about it freely (Downs,2011, pp.1-2).

Furthermore, an effective way of downsizing is to determine the state of the problem between the profit and the employees. In that, laying off people depending on the headcount is not a solution. If the problem is workers, the firm should find a strategic plan that will work out for both the company and the employees. What strategy will help cut costs and retain talented workers? Next, how the company will be after early retirement should be considered by identifying its end goal through having a clear vision of the new organization? Furthermore, for the dismissal to be successful, one has to treat employees with respect by informing them early and respectfully. In addition, while laying off the employees, one should consider the necessary laws, like the employees’ rights and work adjustments (Downs,2011, pp.2-4).

The considerations of the downsizing process are being transparent with employees, telling them in advance, and using a strategy that will consider the work distribution and not the date of employment. Furthermore, let the existing employees freely discuss the discharge of other employees, consider the state of the issue, people or profit, and find a suitable solution. In addition, have a clear plan on how the company will look after the dismissed employees are gone and be respectful of handling the employees being laid off. Lastly, one should consider the necessary laws when dismissing employees. The above considerations are essential to building trust between the employees and the management and improving the existing worker’s working morale (Downs,2011, pp.1-4).

The impact of downsizing on remaining employees is that some feel helpless when the firm cannot embrace what has occurred. Furthermore, they are demoralized to work and have mistrust depending on how late the firm delivers the information to their fellow laid-off workers (Downs,2011, pp.1-4). In addition, they might also have difficulty accepting and adjusting to the situation; some need to talk about it while others avoid the topic. Furthermore, some have a different stress level, while others deal with it through interpersonal conflict, sickness, and accidents (Heathfield,2019).

The requirements of effective downsizing determine the state of the problems if it is people the organization wants to eliminate by eliminating or finding ways of making more profits while retaining the workers. Next, the firm should have a vision of how the company will be after the laying-off period, and respecting the remaining and the discharged employees also matters which should be done by treating them well. Further, considering the various laws when laying off workers can also be productive (Downs,2011, pp.2-3). Additionally, the organization must develop a strategic transition plan to help them throughout the process and ensure their managers know their inspiring responsibility. They also have to involve the Human resource personnel for further consultation and develop the best communication strategy. They should ensure that the laying off information is communicated early and in the right way and be empathetic when communicating the message (“Seven Steps to Smoother Downsizing, 1992).

In conclusion, when laying off employees, the organization should consider the work distribution and not employed date and communicate early and correctly. Furthermore, they should also address the matter accordingly with the remaining employees and consider a more effective strategy between employees and profit to deal with. They should also be respectful to both employees, consider necessary laws, plan how the company will be after the laying-off period and be transparent with the employees on the information. The consideration builds trust among the employees and the management and motivates them. Demoralization, helplessness, mistrust, interpersonal conflict, and sickness impact the remaining employees after downsizing.


Downs, A. (2011). Downsizing with dignity. In J. Law, Business: the ultimate resource (3rd ed.). A&C Black. Credo Reference:

Definition of Downsizing – Gartner Human Resources Glossary. Gartner. (2022). Retrieved 23 July 2022, from

HeathField, S. (2019). The Effects of Downsizing on Employees Who Survive the Layoffs. The Balance Careers. Retrieved 23 July 2022, from

Seven Steps to Smoother Downsizing. Government Executive. (1992). Retrieved 23 July 2022, from

Literature Review – Step By Step Guide For Writing An Effective Literature Review Essay Example

The literature review is about reviewing the research that has already been done about a particular topic. Reviewing prior research done on a specific topic allows the researcher to gain more knowledge about the topic at hand. So, the essence of the literature review is to provide the researcher with a sufficient knowledge base on the topic (Smart Student, 2021). By reviewing what has been written on the topic, the researcher identifies gaps, open questions unanswered by previous researchers, inconsistencies, and conflicts in previous research. Prior to writing the literature review, the researcher needs to know whether the literature review is a standalone assignment or part of a larger assignment. If it is a standalone assignment, the researcher should structure the paper with a cover page, introduction, body paragraphs, conclusion, and references (Smart Student, 2021). However, if it is part of a larger assignment like in a research paper, the literature should be located right after the introduction because it is not the last part of the paper, so it will essentially set up the reader for the rest part of the assignment. Overall, the process of writing an effective literature review can be broken down into four narrow steps, including searching, organizing, structuring, and writing.

Searching involves turning your research topic into a question. It is easier to search for answers to a particular question rather than aimlessly searching for a topic online. The searching step involves looking for the actual information about the topic. The researcher can search for information from different angles. These angles include answers to your research questions, trends or patterns, contradictions or debates, common or recurring themes, or gaps in the research (Smart Student, 2021). Whichever angle the researcher selects, the key is to narrow down the research. The best approach when reading an article is to first read its abstract and the introduction to know whether the information is useful for your research. If it is useful, the researcher can go ahead and read the conclusion and the introduction combined gives a full scope of what is that article. The researcher can further read the table of contents and heading sections to know more about the article. Some of the best places to search for journal articles include the GOOGLE SCHOLAR, EBSCO, MEDLINE, ECONLIT, and PROQUEST (Smart Student, 2021). For example, using Google Scholar requires the researcher to copy and paste the research topic or question to find the potential journal articles written on that topic. In addition to research databases, the researcher can apply networking to find more articles, which involves using references listed in journal articles. Besides the journal articles, the researcher can search for dissertations written on the topic to further research the topic.

The organizing step involves listing the references in an excel spreadsheet or writing an annotated bibliography that gives a summary of each journal article entry used. The annotated bibliography allows the researcher to remember what each journal article is about (Smart Student, 2021). An annotated bibliography consists of 2 main components, including reference list entry and annotation. The annotation is a summary of what is contained in the article, as well as why the summary is important to your research. For example, an annotation can identify a research problem and provide a solution or evidence to your research. After evaluating your sources, the researcher can take some time to digest the information prior to starting the writing process (Smart Student, 2021). For example, taking a few nights before embarking on the writing process allows the information obtained from the sources evaluated to sink in.

Structuring involves selecting the best chronological order to present the information and then creating an outline for it. As far as structure is concerned, there are different types of literature reviews to choose from, including integrative, thematic, chronological, methodological, and theoretical (Smart Student, 2021). Under Integrative, literature critiques the current literature in order to introduce new perspectives. Under chronological, literature is arranged by data in order to analyze the progression of something over time. Under thematic, literature is organized around a main or recurring theme. Methodological compares and contrasts different methods being used. In a particular topic. Finally, theoretical literature compares and contrasts different models and theories. Once the researcher has chosen the type of literature, the next step involves formatting the paper and creating an outline. The researcher should never start writing before writing an outline because it also makes the writing process much easier and faster (Smart Student, 2021). An outline also helps the researcher to present the information in chronological order. The researcher can also create section headings based on the assignment’s instructions.

Writing is the final step of the effective literature review writing process. If the researcher has done proper searching, organizing, and structuring, writing becomes the easiest step. For a standalone assignment, the researcher should focus on writing the body paragraphs first and then create the introduction and conclusion later (Smart Student, 2021). Since the researcher has already written the annotated bibliography, literature review writing involves just putting together the summaries from different sources. The researcher should include the in-text citations and annotations in the literature review to make the writing process much easier. After writing the body paragraphs, the next thing is to write the introduction with a clear thesis statement and a conclusion. The conclusion involves restating the points in the body paragraphs in the order in which they appear (Smart Student, 2021). The last thing after finishing the writing process is to edit and proofread the paper. The researcher can do this by sharing the paper with someone to help you know whether you were effective in your writing.

Socio-economic factors affecting access to education in informal settlements in Nairobi County (Introduction)

There is empirical evidence that socio-economic factors affect access to education in informal settlements. The following literature review confirms that socio-economic factors such as parental involvement, family’s level of income, lack of electricity, inadequate physical teaching and learning materials, all have an influence on access to education for children in the informal settlements in Nairobi County.

Factors Influencing Academic Performance in Urban Informal Settlements in Kenya: A Case Study of Public Primary Schools of Kibera Slums, Nairobi County.

In this Journal Article, KIBAARA & KABURA (2013), admits that although the government is committed to the provision of free primary education to all children, there are still segments of the society that continue to struggle to access basic education. The most affected group are the children living in the slums. The authors agree that although these challenges are common in public primary schools, they are predominant in informal settlements. Due to the nature of informal settlements, particularly in Nairobi County, pupils in these areas face a myriad of socio-economic challenges that affect their academic performance. As a result, some learners in informal settlements are forced to engage in crime, child labor, and prostitution, among others. According to KIBAARA & KABURA (2013), the main socio-economic factors that influence access to education and academic performance in informal settlements include lack of electricity, poor medical care, child labor, lac of food, and the inability of parents to meet other children’s school requirements. Besides the socio-economic factors, the study further established environmental factors that affect academic performance in informal settlements, including tribal intolerance, stereotyping and textbook-pupils’ ratio. Other environmental factors with a significant influence on academic performance in informal settlements according to KIBAARA & KABURA (2013) are the pupils to teacher ratio, poor sanitation, drug abuse, indiscipline, and poor classrooms. KIBAARA & KABURA (2013) also highlights psychological factors like stigma from HIV Aids and other diseases as a cause of poor performance. Overall, this study confirmed that poverty affects the academic performance of students in informal settlements, which corresponds to socio-economic factors affecting access to education.

Parental socio-economic status academic achievement in selected secondary schools in urban informal settlements in Westlands Division, Nairobi County.

This Journal article by Gabriel et al. (2016) is significant to this study because it highlights the parental socio-economic factors that influence the academic achievement of students in secondary schools in informal settlements in Nairobi County. The study found that physical and other essential instructional resources are inadequate in informal settlements. According to Gabriel et al. (2016), there is a positive relationship between the parental level of income and the ability to fiancé education for their children. In addition, the study established a positive correlation between a good teacher-parent relationship and the child’s academic performance. Another key finding of this study is that parental occupation, as well as involvement in educational activities, are key facilitating factors. Therefore, parental inability to finance children’s education, poor instructional and physical resources are key hindering factors to students’ academic performance. The study recommended that there is a need for the government to strengthen collaboration between different educational stakeholders to mobilize learning and teaching resources. Gabriel et al. (2016) further called on the government to control unemployment, which is predominant in the informal settlements and which is a key socio-economic factor inhibiting students’ academic performance. Thus, the study concluded that the government has a responsibility of raising the socio-economic status of people living in the informal settlements to enable them finance the education for their children. Therefore, this study is relevant to the topic as it highlights the key socio-economic factors influencing access to education in informal settlements and also provides potential solutions to address the socio-economic challenges.


In conclusion, there is empirical evidence that socio-economic factors not only affect access to education but also lead to poor academic performance among students in the informal settlements. The two studies highlight the key socio-economic factors that inhibit access and academic performance for students living in the slums. Thus, these studies confirm that socio-economic factors such as parental involvement, family’s level of income, lack of electricity and inadequate physical teaching and learning materials not only affect access to education but also lead to poor performance in the informal settlements in Nairobi County.


Gabriel, M. N., Ngesu, L. M., Muasya, I., Maonga, T., & Mukhungulu, M. J. (2016). Parental socio economic status academic achievement in selected secondary schools in urban informal settlements in Westlands Division, Nairobi County.

KIBAARA, D. T., & KABURA, G. W. (2013). Factors Influencing Academic Performance in Urban Informal Settlements in Kenya: A Case Study of Public Primary Schools of Kibera Slums, Nairobi County.

Smart Student. (2021, March 14). LITERATURE REVIEW: step by step guide for writing an effective literature review. Retrieved from