This essay was written by my junior BSN nursing student, Bethany Rieth as an assignment in her Clinical II course in the University of Wisconsin-Madison School of Nursing. I wanted to share this as it provides a succinct, accurate overview of palliative care from the perspective of a student who is just learning about it- a perspective I feel is relevant to anyone who is learning about palliative care for the first time. I am publishing this here with her permission.
I have had no experience with someone who has been in or wished to transfer to a palliative care unit. Therefore, I wanted to gain some insight about what it is and how it affects those who may be associated with the unit. I was hoping to become a bit more familiar with it, so I can answer basic questions that may arise and to have a better understanding of end-of-life (or those becoming closer to this stage) type situations.
First, I wondered exactly what palliative care was. Palliative care is specialized medical care focused on identifying and relieving the pain and other symptoms of a serious illness. Its goal is to improve quality of life for such patients at any stage of illness regardless of current treatment plans, and it is tailored to the needs of the patient and the family.
After researching, I was surprised to see that more often than not, people refuse palliative care simply because of the idea associated with death and “giving up on life.” Patients assume that this is only for people who are near death and have no other options to survive. However, palliative care can be utilized for anyone facing serious illness and it can be used during any stage. Palliative care can be used to manage symptoms and assist in education of the patient throughout the changes in the patient’s health. They can find day-to-day treatments and guidance from clinicians and physicians, rather than waiting for an upcoming appointment or emergency room visit. It provides a great atmosphere for support, planned care and may ease the stress on the patient or the patient’s families.
The continuity of care is essential in palliative care, and it has proven good results. It often extends the life of the patient, approximately 2 to 3 months longer than a patient who seeks standardized care.
By seeking palliative care within the early stages of illness, it can provide more optimal clinical outcomes. This can include better quality of life, mood, less aggression, and support throughout the stages of illness. They can focus on symptom management and prognostic awareness, which is critical for terminal illnesses and all chronic diseases.
The teams within a palliative care unit are often trained to provide excellent pain management interventions and know the signs/symptoms associated with chronic and severe illnesses. They are great at supporting the patient and the patient’s families through the emotional impact of serious illness and may help lower stress levels throughout the process. They can guide family decisions, provide information and education, and show support throughout each step. Especially for dying patients, preparatory grief has shown importance for both the patient and family. While this is challenging for everyone involved, it is useful to be prepared and transition through the mourning process.
There can be a stigma associated with palliative care, the idea that transitioning there signals a beginning of the end, which may take away patient hope. This is often why the patient or family will resist palliative care and the treatments offered there. It is important to inform them that most of the therapies offered with help patients make better decisions about the types of health care they wish to receive. It is important to distinguish these aspects with the patient, allowing them to make an informed decision about their illness or end-of-life plans.
Reference
Strand, J., Kamdar, M., & Carey, E. (2013). Top 10 things palliative care clinicians wished everyone knew about palliative care. Mayo Clinic Proceedings, 88(8), 859-865. doi:10.1016/j.mayocp.2013.05.020
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