Sam Bielenberg is a 24-year-old person who identifies as

Sam Bielenberg is a 24-year-old person who identifies as non-binary. They were
admitted 6 days ago for IV antibiotic therapy to manage and treat a significant
infected wound on their right foot. Sam has been informed by the orthopaedic team
that if the wound does not respond to the antibiotics, there is a risk amputation of
their foot may be necessary.
Sam has a 10-year history of IV drug use and has not always used clean needles.
They are currently on AWS assessments, although Sam is currently exhibiting less
symptoms then at admission. They are still quite restless and are often asking to go
outside to smoke. Sam currently smokes 40 plus cigarettes a day, especially when
they are not actively using drugs.
Sam has never had any contact with their father, nor are there any siblings. Sam’s
mother was also an only child who had a significant history of drug use and died of
an overdose over 5 years ago. Sam was sexually assaulted by their mother’s
partner from the age of four until they ran away from home at age 14 and Sam states
this led to a diagnosis of PTSD.
After leaving home, Sam dropped out of school and lived on the streets for several
years. They survived by operating as an independent sex worker. Again, this was
not always performed in a safe and healthy manner. Sam admits that they do not
always practice safe sex.
Sam was close to their maternal grandfather who did his best to support them where
he could, although he suffered from badly managed diabetes. This led to peripheral
vascular disease (PVD) and peripheral neuropathy. Sam’s grandfather had bilateral
above knee lower limb amputations over several surgeries, became vision impaired
and suffered from chronic kidney disease (CKD). Sam’s grandfather died recently
from complications of disease processes. Sam attributes this to their latest relapse
with drugs and admits to injecting into their foot.
Sam is hepatitis C positive, which is poorly managed, is suffering from malnutrition
and has been recently treated for an STI.


Describe three (3) concerns/issues that the patient above may be experiencing from the patient’s point of view.

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