Case Study: Amanda Sax
Recall the case example, Amanda Sax that you reviewed in lesson 2 of this course. Amanda was in a motor vehicle accident and has a left above knee amputation.
Answer the following questions related to vocational issues and Amanda’s case before looking at the vocational worksheet.
Review Amanda’s narrative report.
- What are Amanda’s vocational limitations?
- What impact will Amanda’s vocational limitations have on her return to gainful employment? Are these impacts mild, moderate, or severe?
- What is the impact on the range of job alternatives?
- Would you recommend that Amanda pursue a degree in nursing?
Sample response:
- Amanda’s vocational limitations include:
- Alteration of tactile sensation – Right leg tendon donor site.
- Reaching – effected by balance issues related to loss of left leg.
- Lifting and carrying items secondary to balance issues.
- Extended sitting due to prosthetic discomfort.
- Sitting in tight spaces (i.e. airplanes) due to prosthesis bulk.
- Extended standing causes pain in residual limb with and without prosthesis.
- Extended walking due to pain in residual limb.
- Walking limited to use of crutches without prosthesis.
- Walking on uneven terrain increases difficulty and balance deficits.
- Bending limited by function of knee in current prosthesis.
- Nonfunctional for kneeling, stooping and squatting.
- Nonfunctional for repetitive step or stair climbing.
- Balance deficits leading to falls, leaving her vulnerable for secondary injuries.
- Reduced physical stamina due to higher energy consumption required to ambulate with prosthesis and/or crutches.
- Post-traumatic stress disorder related to trauma from incident on 12/30/05.
- Depression, anxiety and poor adjustment to disability.
- Self-image deficits.
- Pre-existing psychosocial issues related to childhood trauma.
- Due to her vocational handicaps and current level of education, it is likely that Amanda will have a mild to moderate impact on job placement. Her ability to be placed in the labor market will likely be decreased without vocational counseling and support.
- Because Amanda will now require employment in a light or sedentary position, there is a moderate to severe impact on her range of job alternatives. Completion of her college education will likely reduce a loss of earnings.
- Employment as a nurse will not be appropriate for Amanda due to the requirements of lifting, prolonged standing, and walking.
- To view the vocational worksheet for Amanda Sax, click here for the document.
