Palliative Care/Gibbs
DESCRIPTION
Palliative care is comfort care for an individual who is no longer in need or desires life saving care. Most palliative care is offered near the end of life. Palliative care often takes a more holistic approach where therapeutic touch, pain management and a higher degree of interpersonal communications occur between the nurse and patient and the nurse and family occur. Members of the health care team often approach the situation by working together to ensure that both patient and family are offered palliative intervention both on a schedule (with pain management care) and sometimes on demand responding to newly emerging needs for both medical and social intervention and information surrounding the comfort needs of the patient. Doctors are often called upon to respond to new orders associated with patient symptoms on a 24-hour period some examples would be ordering increases in pain medication depending on level of pain as it emerges, medical treatment for nausea, or the suppression of seizure activity much of this depending on the condition of the patient. Nursing staff is often asked to obtain or make provision for food and beverage needs of the patient and sometimes the family on an ongoing basis. Support nursing staff, such as unskilled nursing staff is often asked to intervene with increased demands for bed baths and linen changes to support a more therapeutic environment for the patient. Referrals to hospital clergy or patient centered spiritual advisors as well as social work and our counseling intervention when the nurse deems it necessary by her discretion and the nursing staff may also be asked to communicate with and seek visits from loved ones at certain points in the care process, when family or patient requests additional needs. The whole support staff of the hospital may be asked to curtail or increase environmental interventions such as cleaning the patient room or bringing in meals at times when family or the patient desires privacy and then fulfill those needs at a later time off schedule when it is more appropriate for the individual.
FEELINGS
The patient's real and perceived needs are paramount to palliative care, they drive the schedule where there is one for the patient and there may be a heightened sense of need for both medical intervention as well as interpersonal communication regarding assurance of comfort both physically and emotionally. In the palliative care process with one family during a five day period there were several ad hoc interventions needed when the intensity of pain heightened following disease progression and when nausea heightened in the diseases process. The patient was near end stage of a long battle with colorectal cancer and the distention of the abdomen, increased nausea and vomiting coupled with decreased bowel movement and increased discomfort proved difficult for the staff to manage. The patient and family were offered continual intervention through prn medication as well as prompt attention to cleaning and redressing the patient. In the early part of the period the patient required frequent linen changes and emptying of the emesis and bath basin as well as two to three additional bed baths during each shift of care. The patient and family also required an on call directive made to the patient's doctor to increase pain medication as well as prescribe an injectable medication for nausea and vomiting and an increased use of both upon orders from the doctor over the first three days, and declining over the final 48 hours of patient care. In addition many housekeeping duties fell to unskilled nursing staff as frequent bed changes and room clean up and clearance was called for when requested by family and patient, while she was still able to respond to the nurses. In the time frame of the final days of the woman's life there was a clear sense that the patient had the express desire to return home and seek a hospice care referral. The rapid degeneration of the patient made this request an uncomfortable one for family as they were gravely concerned that setting up such care would be unduly stressful on the failing patient and that she would likely not benefit from it even though it was her desire. A bereavement councilor offered by the hospice program came to assist the patient, at the request of nursing staff to ally the family's concerns and assist in the development of a hospice diagnosis and referral for services. The counselor determined that the greatest barrier to the patient going home for...
Palliative Care represents an approach that aims at improving the quality of life of patients and their families experiencing the problem in association with life-threatening illness. This is through prevention and relief of the suffering process by means of early identification of the illness and impeccable assessment and eventual treatment of pain and other related problems. Palliative care offers crucial development to patients by affirming life and regarding death as
Palliative Care Queensland is basically an independent not for profit body that represents the palliative care providers, consumers and their families. This organization is concerned with people who have an interest in palliative care in Queensland (The State of Queensland, 2013). This organization works in favor of the people who want to provide ideal quality care at the end of life for all the residents of Queensland. Since this company
Palliative Nursing FOR END-OF-LIFE CASES Palliative Care Nursing Theories Theories and a Theoretical Framework for Nursing A nursing theory helps structure decisions and practice for the nurse professional (Scribd, 2014). The three major types are the grand theory, the middle-range theory and the nursing practice theory. The use of any of these theories enables the nurse to provide more effective patient care more efficiently. Grand theories deal with the overall nature and goals of
No body of evidence has developed to support these concerns, influential though they have been. It is helpful to recognize that they are not new issues, but have frequently been identified and applied to many groups and individuals. Such concerns have often been associated with traditions of 'protecting' (vulnerable) service users, issues of 'gate keeping' by service providers and paternalistic health and welfare cultures (Brownell, 2006). This is in sharp
27). Participants This study will include a sample of 100 registered nurses working at two large medical centers including nurses working in intensive care and long-term care facilities. The study will also include a sample of 100 patients in the same settings. All participants will range in age from 40-80, and will include a random selection of male and female patients and caregivers. Design, Setting, Instruments Patients will be provided a questionnaire to
Will's desire to withdrawal all life support and refuse his treatment is supported by legal precedent, even though it is likely that his refusal of treatment will result in his death. Conversely, Will does not have the legal right to demand treatment or intervention which would hasten his death. Therefore, were Will placed on life support, and it was known that his desire was not to have such support given to him, then this could
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