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.


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