Nursing Metaparadigm? Sus a 45 year-old Indigenous woman from… Nursing Metaparadigm?Sus S. is a 45 year-old Indigenous woman from Sechelt, BC and is a part of the Shishalh Nation. She receives community case management services from the Indigenous Liaison Nurse for her concurrent disorder of MDD (Major Depressive Disorder) and Acquired Brain Injury. Sus is currently a student studying a Diploma course within the building trades industry.  Sus presented as a person having an “Acquired Brain Injury” as a result of a MVA last year as her primary disability, and with a secondary disability pertaining to a mental health disorder as a result of her acquired injury. Susan has ongoing physical pain and the inability to sit or stand for long periods of time. This together with a mental health disorder manifesting itself by depression, difficulty with sustained of concentration, short-term memory loss, fatigue, low self-esteem, difficulty with acceptance from her peers; and added issues of skill deficits in the areas of time management and writing. She presents as slim, wearing jeans and a sweater that are appropriate for the weather, but are in need of washing. Since her brain injury, she has been able to maintain a passing grade, but is increasingly finding it difficult due to her challenges with focus and memory. During your assessment interview, Sus went to great lengths to explain her journey through her disability, to her eventual decision to take up a trades focused course. She was keen to have teaching staff well appraised of her disability issues in order for her educational accommodations to be taken seriously. During the discussion, Susan disclosed that since her motor vehicle accident she had become a very different person/personality compared to before the accident occurred. When asked to explain, Susan stated that she had a very different personality to the Susan she used to be. She said that although her body and physical features were the same in that everyone she knew recognised her, her personality was not, it was altered. She had become withdrawn and was not the fun-loving carefree person she used to be. Susan lets you know that she had changed her first name to one she thought suited her new persona; such was the depth of feeling towards self acknowledgment of this new personality. Susan needed to inform her world that she had changed. BACKGROUND: Sus is single mother of a 25 year-old son. She lives within the Shishalh Nation band land and has a supportive community, but no other near relatives. Her son still lives with her and he has struggled with his own mental health challenges. Susan still supports him financially as he is unemployed at this time. She rents a 2-bedroom mobile home and was never able to replace her vehicle after the MVA, so she uses public transport. She finds the walk from her home to the bus stop difficult as it is long. She has a student loan that covers her tuition and rent only, she works part time at a local grocery store on the weekends to make ends meet, but it leaves her with little to no spending money. She is up to date on her bills, but only because she supplements her spending on her credit card, which is nearly maxed out. Her supplemental expenses include groceries, laundry services, utilities, transportation, and her sons’ expenses. She has one good friend, an elder in the community, whom she confides with. She shares with her friend that she left home early with a boyfriend, the father of her son. He was from Sechelt and a member of the Shishalh Nation. He became abusive and she left him, but he moved away while she stayed. She does not have a relationship with his family at this time.  Questiondiscussion on the concept of “Environment” and then application of the PSR Core Values and Principles to the concept of “Environment” and “person. based on nursing metaparadigm o2.From a nursing perspective, discuss the concerning areas and strengths for Susan. Be sure to discuss four interventions in this domain based on Susan’s concerns/ areas of strength.Health ScienceScienceNursing NURSING 494

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