Veterans Education Toolkit
Advancing Care Excellence for Veterans
Case: Butch Sampson (Vietnam War veteran)
Author: Janet K. Willhaus, PhD, RN
Boise State University
Overview: Butch Sampson, age 62, was exposed to Agent
Orange during his service in Vietnam. Chronically homeless, Butch has Type 2 diabetes
resulting in the removal of two toes. During the first two simulations, Butch is in a
Veterans Administration hospital for surgical debridement of his great toe. The nursing
focus is on assessment of his foot, medication administration, diet teaching, and planning
for his needs after discharge. He is discharged to a temporary housing facility, but during
a visit by the home health nurse in Simulation 3, we find that Butch is in danger of being
evicted because he has been smoking in his apartment, a violation of the rules.
Monologue: Butch has come to the VA clinic because of
an infected toe. We learn that he is homeless, fiercely independent, and very suspicious of others.
Butch's Introductory Monologue
||Click here to download an audio file.
||Click here to download the script for the audio file.|
||Click here to download an Instructor Toolkit that contains
suggestions for discussion of Butch's monologue.
Simulation Scenario 1
Butch was admitted to the VA hospital with cellulitis of the right great toe and had a
surgical debridement. His diabetes is out of control and he is a smoker. The nurse will
assess his wound, administer his IV antibiotic, and begin some teaching.
Simulation Scenario 2
Butch is being discharged from the VA hospital to a transitional housing facility. He is
somewhat resistant because of all the rules he must follow. The nurse will review all
discharge instructions, provide additional teaching as needed, and complete the medication reconciliation form.
Simulation Scenario 3
When the nurses make a home health visit to assess and redress Butch's foot, perform a
safety assessment of the home environment, check his blood sugar, and determine if he is
following his diet and taking his medications, they discover that Butch is in danger of
being evicted because he was caught smoking in his apartment, a violation of the rules.
for Simulation 3 Template
for chart materials appropriate for Simulation 3
for Instructor Toolkit ideas for use with all simulations
Finish the Story Assignment
Learners have now seen Butch at three snapshots in time. What do they think his life will be like three months from now?
for ideas on how this assignment could be implemented.
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