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Reflection on Palliative Care

Last week, I was assigned under a registered nurse (RN) to take care of an old lady who was going under regular sinus surgery. The patient was admitted early morning for the surgery during which her airways collapsed during anesthesia. This led to very little oxygen available for her brain and the rest of the vital organs of the body, resulting in serious brain damage leading to her death. The patient was not improving with this procedure and had a desire to shift in a private single room for a specific environment, still, the RN did not communicate this information to other associated health professionals and the senior health professionals later planned to carry out the surgery.

I felt very nervous during the entire scenario and felt very unsafe and bad for the patient because this failure of effective communication leads to the death of an innocent patient. I felt that the health professionals were unable to effectively communicate and take actions accordingly and that ultimately resulted in poor quality care of patients and a threat to her life.

The positive element of the event was the health professionals realized their fault of not a failure in communication. The negative part was very bad as it included the death of an innocent patient. The RN knew that the patient is not improving with the surgery and despite approaching a new or different method or informing the senior doctors, the RN let them use the same method and that ended up in the death of the patient. According to Müller et al. (2018), effective communication in palliative care provides quality care to the patient and also ensures the patient’s safety. As in this case, the patient needed a peaceful private environment that was not provided to her leading in her effected environmental aspects – no privacy and palliative care environment. In old age, a peaceful environment has a great impact on improving health.

I learned that effective communication with patient and health professionals ensure the delivery of quality care. The patient’s needs should be fulfilled to ensure her satisfaction and ambient/private environment in a palliative care result in improved outcomes. The lack of mutual communication and collaboration failed the consultants and the nurses led to a critical situation that resulted in a patient’s death (Australian Institute of Health and Welfare, 2020). The RN present at the time of surgery was aware of the important patient-related information; still did not share which didn’t go well in this case study. A failure in ineffective communication led to a collapse in the decision-making process. A failure in communication among the health professionals led to this negative situation. Moreover, a particular environment in palliative care can either motivate the patient to live or led to stressful conditions. During palliative care, creating and maintain an environment of care contributes to many factors like enhancing safety or comfort and optimizing the patient’s experience. Culturally, if the patient is from an educated and open-minded background, then she/he will actively get involved in her/his decision-making and family involvement decision-making as well (Robinson et al., 2018). This results in effective feedback and a strong relationship between the patient-nurses but if the nurses do not take advantage of such points then the health of the patient might not improve at a good pace.

The RN should always meet the needs and demands of the patient. The patient’s feedback should always be taken under serious consideration ensuring that safe and quality care is provided. The health professionals should have strong communication among associated care providers about the details of the patient’s progress/deterioration of health so that an effective plan can be made and implemented as soon as possible. According to Cain et al. (2018), cultural backgrounds can impact palliative care and decision-making because some patient's decisions are based on their beliefs that create difficulty for care providers to implement the care plan as per the patient’s beliefs. A belief in god can be used in some cases to cope with the patient in his/her situation whereas in some cases the beliefs can negatively impact the criteria of care provided by the care providers.

If a similar situation occurs in the future, then I will ensure that the patient is provided with a proper environment, his/her cultural beliefs are taken into serious considerations. The patient’s requirements should be met and treated with dignity. If the patient is not improving with a particular method then as per his/her progress report an alternative new/different method should be executed for care as soon as possible and there should be no failure of communication among the care providers and with the patient as well. As the decision in palliative care taken by the nurses is very important for the patient’s health so, the RN should always share complete details of the patient with the seniors or associated care providers (Avati et al., 2018). According to Brighton & Bristowe (2016), a timely and effective decision can change the actual outcome of the critical situation resulting in a positive outcome. Without a failure of communication, collaborative and comprehensive care will be provided to the patient as every patient has the right to a safe environment and quality care. The factors like cultural and environmental aspects should be taken into serious considerations in palliative care because effective care will relieve the pain of the patient and offers a support system to encourage the patient to recover from complex situation as soon as possible.

References for Improving Palliative Care with Deep Learning

Australian Institute of Health and Welfare. (2020). Australia’s Health. Retrieved from: https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf

Avati, A., Jung, K., Harman, S., Downing, L., Ng, A., & Shah, N. H. (2018). Improving palliative care with deep learning. BMC Medical Informatics and Decision Making18(4), 122. https://doi.org/10.1186/s12911-018-0677-8

Brighton, L. J., & Bristowe, K. (2016). Communication in palliative care: Talking about the end of life, before the end of life. Postgraduate Medical Journal92(1090), 466-470. http://dx.doi.org/10.1136/postgradmedj-2015-133368

Cain, C. L., Surbone, A., Elk, R., & Kagawa-Singer, M. (2018). Culture and palliative care: Preferences, communication, meaning, and mutual decision making. Journal of Pain and Symptom Management55(5), 1408-1419. https://doi.org/10.1016/j.jpainsymman.2018.01.007

Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: A systematic review. BMJ Open8(8). http://dx.doi.org/10.1136/bmjopen-2018-022202

Robinson, J., Gott, M., Gardiner, C., & Ingleton, C. (2018). The impact of the environment on patient experiences of hospital admissions in palliative care. BMJ Supportive & Palliative Care8(4), 485-492. http://dx.doi.org/10.1136/bmjspcare-2015-000891

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