Reflective Essay for Non Pharmacological - myassignmenthelp.com

Question: Write about theReflective Essay for Non Pharmacological Treatments. Answer: In my career I have come across many critical cases and have dealt with it efficiently. I have also served those people who were terminally ill and have tried my best to improve the quality of care in their last days. This essay is based on my experience with a lady, whom I have served during her last days. It is about Anne. Anne was a 37 years old vibrant lady and was leading her life happily, until she found that she was suffering from breast cancer. It illness was in the advanced stage and she came to know that she had only 6 months in hand. She had a child who was only 7 months old and was still breast feeding her. She had to undergo chemotherapies and radiations; as a result she had to stop breast feeding. Her whole life was shattered. I was her only care giver during her last days. I dedicated my full time to provide an undivided attention to Anne and after her scheduled time she had to go to a world of eternal piece. When a person suffers from an emotional turmoil when she him self understands her last days had come (Corr and Corr. 2012). It becomes very difficult for the patient as well as the patients family to come up with such a difficult situation. Cancer is a deadly disease which involves a lot of pain, anxiety, psychosocial problems. In this essay I have focused on the different phases that the person and his loved ones go during this stage. I will discuss how the changing patterns of the death affect the community of the individual. I discuss the modes of treatment that I have provided her to improve the quality of his life. I will critically mention about my role in their care, the probable interventions to deal with this condition. I have also thrown light on the effective communication strategies that has to be adopted in order to provide support to the patient, physically, mentally and spiritually (Phelps et al. 2012). In the latter part of the essay I have noted about the pharmacological and the non pharmacological treatments that I have prov ided to the patient in the case study. I have come across the changing patterns of the mortality world wide and have paid particular attention to the differences, which exists between the developed countries. In the last year of their life people often do not get help, many experience disconnected, distressing and confusing array of services. A good death provides people dignity, choice and support to the address the physical, personal and the spiritual needs. Most of the people want to spend their last hours in a home like settings (Zimmerman eta l. 2014). We need more public reforms about the limitations of the health care as the death comes nearer. We need to plan in a better way to ensure that we have proceeded according to the patient. For more people to die at home a community based support is required. There are some people who choose to stay within a healthcare setting during their death. It is our duty to try the best to fulfill their requirements and their desires. In the given case study Anne could spend her la st days at home looking after her 7 months old daughter. Had she been in the hospital, she wouldnt have got the mental and the spiritual support that she deserved during her last days. Women with breast cancer, faces a wide range of practical, medical and emotional challenges that affects their quality of life. They are faced with emotional distress, social functioning. Firstly the treatment of the metastatic breast cancer involves a lot of social concern. Firstly the physical burden followed by emotional distress, disturbances in the shape of the body (Teno et al. 20130. In this case we have already come across the facts that Anne had a small daughter. Therefore as a mother it is very difficult on her part to accept the fact that she had to leave her daughter forever very soon. The social constraints raised on disclosure of the cancer can also enhance the distress of the patient. As a person nears the end of his journey it is very difficult to know what to expect. Responsibilities of the caregivers may vary depending on where the person is getting the care. Regardless of every situation I have tried my best to provide the best possible care to the patient. I have ensured in every possible ways that the person dying is comfortable. In this case Anne who is a mother of a small child, was suffering from extreme mental trauma with the thought of leaving her daughter forever. It is the duty of the family members to assure him and provide mental support. In this case we assured Annie that her daughter will be alright even after her death. Few approaches that can be taken up are- Provision of the eggshell mattresses for making the beds comfortable, positioning of the person in the position in which he is convenient with, to make the breathing easier or to ease the pain. Speaking in a calm and polite voice and reminding the person of her good days (Hui et al. 2014). If the person is unresponsive we must say supportive or reassuring sentences, offering of small sips of fluid to maintain the hydration. Glycerin swabs or lip balms can be provided (Peters et al.2013). Massaging a persons body such that provides her with comfort and also increases the blood circulation. We would try to relive the pain by giving painkillers. This may require careful planning with the palliative team members (Heyland et al.2013). A person with cancer and the caregivers should be well aware of where to contact for help if adverse condition persists. I would like to discuss further on few points like Living will, health care attorney. A health care power attorny is a person, whom the p atients select to make health care decisions, if the person is unable to do. Living will is a document that accounts for the type of medical treatment that the terminally ill (Lewis. 2013). Therefore as a caregiver it is our duty to follow the advance directive in order to help the person die with peace and dignity. Organizing the practical matters in advance, lower the stress of care giving for the nurses. A list of people should be prepared that the person wants to meet at the time of care giving (Phelps et al. 2012). The persons who should be present at the time of death should be considered, for example few people prefer the presence of the spiritual leaders at the time of death (Maltoni et al. 2012). Although dying is part of the human journey but dying poorly is not. A meaningful dying is one when the patient is physically, psychologically, emotionally and is spiritually supported by her family and the caregivers (Balboni et al. 2013). According the Institute of Medicine a good death is one where the patient is free from all distress, and this condition can be achieved by following the above mentioned interventions. A good death evokes a feeling of relief in the family of the patient. A good death also poses a sense of relief and satisfaction in the minds of the care givers, that they have given their part of care to the patient, to make him feel better. As a nurse I have always followed this rules and ethics which have helped me to develop my skills as a nurse to deal with such sensitive situations. I do strongly believe that effective communication is one of the essential parts of the end of life care treatment that are provided to the patient. As the healthcare worker in the palliative care department, I need to have the skill of effective interpersonal communication that can help in the process of dealing with the complications encountered by the patient and their family. It is important for the nurses of palliative care to have the skills of both verbal and non-verbal form of communication that is an essential part of the treatment. In the case of Anne, she and her family were mentally devastated due to her terminally ill condition. With the help of the effective communication skills, it was possible for me to provide the mental support that is needed in the given case. With the help of the mental counseling that is achieved with the help of effective interpersonal communication, it is possible to provide full empathy to the patient. It is also important for the nurses to provide the correct information about the physical status of the patient. It is believed that the nurse and the healthcare workers need to use special communication strategy in order to deal with the complications that are associated with the patient care (van Eechoud et al. 2014). The effective communication is also an essential part that is needed to deal with the spiritual support to the patients during the time of terminally ill condition. In my case, I used to follow a certain strategy of communication that was filled with positive thoughts. This helped the patient to have full faith upon my strategy and she was able to share all her personal concerns. It is essential for the patient with terminal illness to have both pharmacological and non-pharmacological interventions that is needed to support their physical and mentally ill condition (Yamagishi et al.). With the development of the critical care and modern medicine, it is possible for the patient to provide with the best quality of treatment that is needed to deal with the major relevant complications. It is important to mention in the context that chemotherapy, which is the major form of treatment for cancer is generally associated with the high level of side-effects. This may include tremendous pain and feeling of nausea. Under those circumstances, it is common of the patient to suffer from the mental misbalance and may not wish to continue of the process of treatment. It is my duty as the nurse to convince the patient and encourage them to overcome the complications of the side-effects that are associated with the intensive treatment like the chemotherapy for cancer. I do strongly believe that in such a critical care condition, it is important for the nurses to provide the mental support care that is a significant part of the non-pharmacologic treatment provided to the patients. It has been seen in several occasions that with the help of psychological therapy like the placebo effect, it is possible to provide to provide the mental comfort to the patient. I have used this technique to maximum extent in case of Anne, which did help her to gain the temporary mental support that is needed in the given context. I have to receive the training for cognitive therapy that is needed to deal provide the mental and spiritual support to the patient in the forms of non-pharmacologic treatment methods for the terminally ill patients. I have faced ethical issues in the past while dealing with the patient of critical and terminal care. With the evolution of the medicine, it is possible to expand the lifespan of the individual. It is important for the medical practitioner to take effective decisions in regard to the type of treatment that is to be provided to the patient that can help them to survive for longer duration (Corbett 2015). It is important to mention in the context that even with the modern and developed treatment methods, it is never possible to fully cure the condition of the terminally ill patients. Nevertheless, it is important for the medical practitioner to ensure that best quality of treatment is being provided to the patients that can help them to survive for longer duration. It is my duty as the nurse of to ensure that the patient family can accept the facts relevant to deterioration of the medical condition of the terminally ill patients (Hui et al. 2014). In case of Anne, there was high level of expectation of the patient family as due to her young age. From the experience that I have gained with the case like Anne, helped in the development of my nursing career. With the help of the nursing experience, I firmly believe that the treatment culture that is provided within the healthcare system of terminally ill patient is an essential component that helps to provide the best quality of treatment. Dying is the ultimate part of our journey through life. A meaningful death is one when the patient is physically, emotionally, spiritually and mentally supported by his families and the care givers. This report critically discusses about the possible interventions to improve the quality of dying and let the patient die in peace and dignity. As a caregiver we should provide moral support to the terminally ill patient. The report also says that in some cases it is a community based effort to provide a proper care to the critical patients. We have discussed about the different communications strategies that would provide a positive outcome in the patients life as well as well as his loved one. A proper care on my part had also built a satisfaction in me. References Balboni, T.A., Balboni, M., Enzinger, A.C., Gallivan, K., Paulk, M.E., Wright, A., Steinhauser, K., VanderWeele, T.J. and Prigerson, H.G., 2013. Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.JAMA internal medicine,173(12), pp.1109-1117. Corbett, N., 2015. Being Mortal-Atul Gawande. Dalhousie Medical Journal, 42(1). Corr, C. and Corr, D., 2012.Death dying, life living. Nelson Education. Heyland, D.K., Barwich, D., Pichora, D., Dodek, P., Lamontagne, F., You, J.J., Tayler, C., Porterfield, P., Sinuff, T., Simon, J. and ACCEPT (Advance Care Planning Evaluation in Elderly Patients) Study Team, 2013. Failure to engage hospitalized elderly patients and their families in advance care planning.JAMA internal medicine,173(9), pp.778-787. Hui, D., Kim, S.H., Roquemore, J., Dev, R., Chisholm, G. and Bruera, E., 2014. Impact of timing and setting of palliative care referral on quality of end?of?life care in cancer patients.Cancer,120(11), pp.1743-1749. Hui, D., Nooruddin, Z., Didwaniya, N., Dev, R., De La Cruz, M., Kim, S.H., Kwon, J.H., Hutchins, R., Liem, C. and Bruera, E., 2014. Concepts and definitions for actively dying,end of life,terminally ill,terminal care, and transition of care: a systematic review. Journal of pain and symptom management 47(1), pp.77-89. Lewis, K., 2013. How nurses can help ease patient transitions to end of life care: Many issues combine to enable an individual to achieve a good death. Kellie Lewis discusses these factors as well as the barriers staff must overcome.Nursing older people,25(8), pp.22-26. Maltoni, M., Scarpi, E., Rosati, M., Derni, S., Fabbri, L., Martini, F., Amadori, D. and Nanni, O., 2012. Palliative sedation in end-of-life care and survival: a systematic review.Journal of Clinical Oncology,30(12), pp.1378-1383. Peters, L., Cant, R., Payne, S., OConnor, M., McDermott, F., Hood, K., Morphet, J. and Shimoinaba, K., 2013. How death anxiety impacts nurses caring for patients at the end of life: a review of literature.The open nursing journal,7, p.14. Phelps, A.C., Lauderdale, K.E., Alcorn, S., Dillinger, J., Balboni, M.T., Van Wert, M., VanderWeele, T.J. and Balboni, T.A., 2012. Addressing spirituality within the care of patients at the end of life: perspectives of patients with advanced cancer, oncologists, and oncology nurses.Journal of Clinical Oncology,30(20), pp.2538-2544. Raijmakers, N., Galushko, M., Domeisen, F., Beccaro, M., Lundh Hagelin, C., Lindqvist, O., Popa-Velea, O., Romotzky, V., Schuler, S., Ellershaw, J. and Ostgathe, on behalf of OPCARE9, C., 2012. Quality indicators for care of cancer patients in their last days of life: literature update and experts' evaluation.Journal of palliative medicine,15(3), pp.308-316. Teno, J.M., Gozalo, P.L., Bynum, J.P., Leland, N.E., Miller, S.C., Morden, N.E., Scupp, T., Goodman, D.C. and Mor, V., 2013. Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009.Jama,309(5), pp.470-477. van Eechoud, I.J., Piers, R.D., Van Camp, S., Grypdonck, M., Van Den Noortgate, N.J., Deveugele, M., Verbeke, N.C. and Verhaeghe, S., 2014. Perspectives of family members on planning end-of-life care for terminally ill and frail older people. Journal of pain and symptom management, 47(5), pp.876-886. Yamagishi, A., Morita, T., Kawagoe, S., Shimizu, M., Ozawa, T., An, E., Kobayakawa, M., Tsuneto, S., Shima, Y. and Miyashita, M., 2015. Length of home hospice care, family-perceived timing of referrals, perceived quality of care, and quality of death and dying in terminally ill cancer patients who died at home. Supportive Care in Cancer, 23(2), pp.491-499. Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl, N., Oza, A., Moore, M., Rydall, A., Rodin, G., Tannock, I. and Donner, A., 2014. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial.The Lancet,383(9930), pp.1721-1730.