Essay on "Life Situation Can Create"

Essay 10 pages (4073 words) Sources: 1+ Style: Harvard

[EXCERPT] . . . .

life situation can create a lot of problems in terms of communication.

The natural thing is to want to heal the person so when that doesn't work, people feel stymied and angry. Communication in any such instance is difficult. For the palliative team that consists of different individuals teaming together to provide quality care for the patient this is all the more difficult. This is because the different members of the team - caseworkers, physicians, nurses, relatives, and friends -- have the same objective, to help the patient, but the stress and different ways of achieving that objective may merge into conflict. People who are close to the dying may feel this particularly so, and nurses who acts as intermediary between patient, physician, and family are often caught in the middle. The result are feelings that include guilt, low self-esteem, anger, misinterpretation and so forth all of which can exacerbate the situation and instead of the palliative team collaborating in making the patient feel most secure and comfortable, energy can become distracted into destructive conflict.

It is very important too that the nurse have all the information in order to provide quality care, but often times patients are confused, and anger and/or fuzzy miscommunication makes an already depressing situation even more negative and toxic. Micommunication or impediment of communciation can, at worst, worsen the patient's condition even resulting in critical issues occuring as a result.

It is to that end, that communication needs to be drastically worked on so that each member of the team is able to insert their best and most unique effort into efficiently and effectively communicating one with the other so that all can work together to the same end.

Tecomemndaitosn for nurse

Whether acute care nurse or hospice nurse both have to have excellent interpersonal skills with patience and ability to listen to the other. With the hospice nurse this is particularly important, since the brunt of her job depends more on listening to, being with, and making the patient feel good than actually treating the patient. She must also have the ability to remain calm and rational through extremely emotional situations and to assist others to deal with these situations in their best way.

As with the acute care nurse, the hospice RN has to be familiar with the ability to prescribe, diagnose, and treat her patient in all manners of ways, as well as monitoring that the nursing care is being provided as necessary.

The therapeutic relationship is different between the two professions by virtue of the fact that the former (acute care) is a short-term relationship and, therefore, emphasis is on physical treatment and monitoring of the patient with the intention of him (oftentimes, although not always) recuperating. The objective is towards the goal of effective recovery or, at least, helping him towards the motions of recovery. Hospice care, on the other hand, is a long-tem procedure, sometimes it may last for years, with the caregiver well-aware that the hospice serves as the patient's last home and is a substitute for medical care. The emphasis here is on therapy to domination of medical care, where the hospice nurse doubles over as counselor and confidante and where maximum value is placed on characteristics such as patience, empathy, communication, friendliness, and equanimity.

As Jaffe and Ehrlich (1997) demonstrate, hospice nursing differs entirely from other forms of nursing in that whilst other nurses attempt to preserve life, focusing on prevention and treatment, and, secondarily, on communications, the hospice nurse advocates, innovates, and educates. The chance for traditional methods of healing has passed. Now all the patient is left with is to live out the rest of her life in comfort, and whilst her medical system is maintained, the hospice nurse considers herself free to innovate in order to make that regimen as comfortable as possible for the patient. To this end, the hospice nurse summons a multidisciplinary spectrum of professionals -- such as chaplains, social workers, nutritionists, psychologists, and therapists -- to help her in her job.

As an aside, as with any nursing profession, in general, and with helping the dying person, in particulr, I realize that the practitioner / caregiver has to be mentally and physically healthy herself before she can help others. A licensed practical nurse, particularly if she is to help others make the most of their last dying moments, has to be aware of the preciousness of life and what it means to make the most out of it as well as to take care of herself and not allow herself to be depressed and frustrated by the challenging situation. By caring fior herslf, it will be easier to commucnaite with othrs and to be abel to negotiate stress better. This si paritucalry improatn sicn estress is an unavoidable nad regular compoentn of her life.

Tecomendations for people

Thirdly, being aware of Kubler's stages of death and relying this information to Mrs. Thomas and husband will be helpful. Elisabeth Kubler-Ross presented five distinct stages that a person goes through before he or she expired consisting of denial, anger, bargaining, depression, and acceptance. Each and every person goes through at least two of these stages although not all in the same order. Awareness of the ubiquity of these stages and their being experienced by both Mrs. Thomas as well as her immediate family will better help them deal with the situation. Hence, this is another strategy that I will employ to help Mrs. Thomas and her family move closer to the reality of her death. The five stages, in elaboration, are: Denial: The individual seeks to deny the reality of his or her situation feeling that this cannot be happening to her; Anger: Frustration, rage, and envy particularly so if the individual is young or relatively young as in the case of Mrs. Thomas; Bargaining -- The individual bargains with a higher power promising this higher power self-reformation or specific types of sacrifice in return for prolongation of life. It may also take the form of reliving past experiences, fantasizing how one may have strategized so that things would be different. In this instance, the Thomas family may be berating themselves over actions that they could have taken to prevent the cancer; Depression -- the individual (and others close to the individual)_ retreats within herself to mourn loss of her extension of life and to attempt to come to grips with that reality; Grief where the individual may refuse visitors, spend much of the time crying and grieving, and become silent; and finally acceptance where the individual is reconciled to the inevitability of her demise.

In aparitucalry moving story, Jaffe and Ehrlich (1997) talk about a dying preacher who was trying to reconcile his family to his approaching death and the RN nurse's advice was particularly thought provoking in that she urged him not to fight the pain but to recognize it and to focus on life despite it. This would be my message -- not only for myself in turns of enabling me to go through the emotional circumstances but also to help my patient and those related to my patient (whether Mr. Thomas in this case or the extended family) deal with the pain and focus on making the most of the remaining moments. My recommendation would be to recognize the pain but to continue despite it so that all individuals in this scenario -- Mrs. Thomas as well as Mr. Thomas and their children can make the most of the remainder of Mrs. Thomas' life.

Tecommendaitons for the family

Carign for a dyign person si but one of many different stressors that hit the family at oen go and cvan become overwhelming, paritualry if other emtoiosn sucha as loss, sentumetn, or guilt are involed. A wonmderful model that has been developed for just sucha sitution consists of the I would use the diathesis model of depression helpful since it merges all explanatory accounts of and treatments related to depression and provides a holistic method. The diathesis model was created by Schotte et al. (2006) who recommended a two-tier model of depression built upon a psychobiological approach. The first tier offers a descriptive diagnosis of depression, whilst the second tier is therapy-oriented and connected to a biopsychological theory.

The treatment phase of the model proceeds in three stages. 1. The demoralization phase aims to educate the Mr. Thomas as well as his family regarding the details of his condition using the biopsychological perspective as a framework (i.e. that his condition is caused by a combination of biological and psychological components particularly stress) and my aim would be on generating hope that Mr. Thomas, with the help of family and friends, can overcome his depression. Counseling skills and patience will be used to break down depression whilst emphasizing and making Mr. Thomas aware of the possibilities for remission. 2. The remediation or symptom reduction phase stresses that the patient need not be actively involved with recovery, therefore he… READ MORE

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