AgDARE - Agricultural Disability Awareness and Risk Education

Spinal Cord Injury - Narrative Simulation

What Happened To Bob?

Purpose

This simulation exercise is a story about two teenagers who are cousins. The exercise is based on discussions with parents and their children across Kentucky, Iowa, and Mississippi. The exercise also includes information from University of Kentucky researchers about economics, productivity, health, and injury. The purpose of the exercise is to tell the story of Bob and Henry in a way that lets you experience some of the decisions the characters face as they experience, and then cope with, a serious farm injury. We hope the exercise is meaningful for you and will help you develop safe farm work practices.

Credits

This simulation exercise was initially developed in 1999 by Pamela Kidd, Deborah Reed, Henry Cole, Daniel Rosnik and Tim Struttmann at the Southeast Center for Agricultural Health and Injury Prevention, the Kentucky Injury Prevention and Research Center, and the University of Kentucky College of Nursing under the United States Department of Health & Human Services/United States Public Health Service/Centers for Disease Control & Prevention/ National Institute for Occupational Safety and Health (NIOSH) Grant #1 RO1 CCR414307 to the Southeast Center for Agricultural Health and Injury Prevention, Deborah Reed, Principal Investigator. The views and conclusions contained in the document are those of the authors and do not necessarily represent the official policies or recommendations of NIOSH, the University of Kentucky or any department or agency of the government of the United States or the Commonwealth of Kentucky.

Instructions

You should have three items to complete this simulation: A problem book, an answer sheet, and a pencil. Read the background information and problem situation described on the following pages. Next, answer each of the questions one at a time. Do not mark your answers in the problem book. When you have selected an answer to a question, look up its number on the answer sheet, and circle T if the answer is true or F if it is false. Some questions may have more than one true answer. Don't jump ahead. As you work the exercise, look at the background information about "What Happened to Bob?" as often as you need to. It's okay to look back to earlier questions and answers, but please don't change your answers.

When you have finished, you will learn how to score your answers. You will also receive a master answer sheet that will explain why each answer is true or false.

Background Information

Bob and Henry

Bob and Henry are cousins. It is summer and Henry is visiting Bob's family. Bob lives on a farm and has worked with his dad and driven tractors since he was eight years old. Now Bob is 14. Henry lives in the city. He looks forward to coming to Bob's house each summer for a long visit when school is out. Now that Henry is 14, Bob's dad is paying him to work on the farm.

Problem

It is a beautiful summer day. The last chore for the boys is to pick up the few remaining square hay bales. They want to complete this task in time to go over to a friend's house. They plan to ride into town with their friend to see a movie.

Bob is driving the old, narrow-front tricycle 35-hp tractor while Henry tosses the bales onto the wagon. When they are about half way done, Bob looks back to see if Henry is getting tired. Before he knows it, Bob runs the tractor into a gully at the edge of the hayfield. The tractor overturns. In an instant, Bob is thrown from the tractor and lands against a rock. Bob lives but his lower back is broken.



Question A

Which of the following could have prevented this injury?

1. A Roll Over Protective Structure (ROPS) on the tractor and the operator wearing a fastened seatbelt

2. Using a newer tractor

3. Using a tractor with more horsepower

4. Having Henry drive the tractor

5. Bob paying attention and watching where he was going

Some hours later, Bob is in a trauma hospital, where he was taken by helicopter. His parents are at his bedside when the doctor comes in and tells them that Bob will be paralyzed from the waist down for the rest of his life. Now he must use a wheelchair.

Question B

Which of the following statements about Bob are true for the rest of his life?

6. He will be unable to walk without assistive devices

7. He will not have normal control of his bowels and bladder

8. He will have difficulty making love

9. He will be at risk for deep and festering skin sores

10. As he gets older the paralysis will spread to the rest of his body

After several weeks in the hospital, Bob finally returns home. Bob's parents realize his injury will affect everyone in the family. Bob will require a level of care that most families are unprepared for.

Question C

Which of the following issues may Bob's family face?

11. Fear and anxiety about Bob's well-being and future

12. Costs of Bob's treatment and special needs since he'll be cared for at home

13. Anger about a situation over which neither Bob nor the family members feel much control

14. Decisions about who in the family will help Bob get around

15. Physical exhaustion from the added work that Bob's paralysis requires from family members

16. Loss of the family farm due to financial hardships caused by Bob's injury and care

Over the next year, Bob begins the slow process of adjusting to his injury and the fact that his life has changed dramatically and forever. His parents notice his mood has changed substantially. He often stares out the window with a sad look on his face, and usually doesn't feel like talking to anyone. When he does talk, he often is irritated and cranky. He no longer enjoys some of his favorite foods or video games. He often wakes up at night after having nightmares about his injury.

Bob's parents try to encourage him when he goes for physical therapy. But he doesn't want to cooperate on most days and says, "I'll never be able to do these exercises right. I can't do anything anymore." Even friends aren't able to cheer him up. When they come over for a visit, Bob acts embarrassed and barely talks at all.



Question D

What might explain Bob's behavior?

17. Depression

18. Difficulty in adjusting to his injury

19. Loss of self-respect

20. Brain injury

Two years after the injury, Bob is beginning to feel more like his old self again. Though it's been very difficult adjusting to his new life, with the help of his family and pastor, with whom he talks once a week, Bob's old personality returns.

Before the injury event, Bob always talked and dreamed about becoming a farmer one day. He knows now that this is going to be difficult, but he is determined to try. Bob also wonders about what other things may be possible for him in the future.

Question E

Which things are Bob capable of doing in spite of his spinal cord injury?

21. Drive a car

22. Go swimming

23. Have children some day

24. Participate in track and field events

End of the story

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